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General NPI Number Information
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NPI Number | 1104105964
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Entity Type | Organization
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Legal Business Name | MICHELE COHEN AND ASSOCIATES, PA
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Dates
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Enumeration Date | 08/11/2011
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 2999 NE 191ST ST SUITE 703
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City | AVENTURA
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State | FL
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Zip | 33180-3123
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Country | US
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Telephone | 305-933-9779
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Fax |
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Provider Business Mailing Address
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Address Line | 1990 NE 191ST DR
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33179-4354
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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 | VICE PRESIDENT
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Name | STANLEY HYMAN
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Credential | PHD, LCSW
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Telephone | 305-933-9779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY4199
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License Number State | FL
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