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General NPI Number Information
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NPI Number | 1093213100
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Entity Type | Organization
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Legal Business Name | MANAL MICHAIL LMFT CORP
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Dates
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Enumeration Date | 01/24/2018
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Last Update Date | 01/24/2018
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Provider Practice Location Address
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Address Line | 8401 LAKE WORTH RD # 201
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City | LAKE WORTH
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State | FL
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Zip | 33467-2400
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Country | US
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Telephone | 954-815-3464
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Fax |
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Provider Business Mailing Address
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Address Line | 8401 LAKE WORTH RD # 201
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City | LAKE WORTH
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State | FL
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Zip | 33467-2400
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MANAL MICHAIL
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Credential |
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Telephone | 954-815-3464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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