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General NPI Number Information
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NPI Number | 1083349948
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Entity Type | Organization
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Legal Business Name | DNA PEDIATRIC COUNSELING SERVICES & RESOURCES
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Dates
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Enumeration Date | 07/23/2022
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Last Update Date | 07/23/2022
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Provider Practice Location Address
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Address Line | 9351 E HEATHER LN
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City | MIRAMAR
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State | FL
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Zip | 33025-2638
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Country | US
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Telephone | 786-356-9394
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Fax |
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Provider Business Mailing Address
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Address Line | 2413 MAIN ST # 545
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City | MIRAMAR
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State | FL
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Zip | 33025-7809
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Country | US
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Telephone | 305-707-0728
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | SHIRLEY MATHIEU
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Credential | LCSW
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Telephone | 786-356-9394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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