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General NPI Number Information
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NPI Number | 1144621830
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Entity Type | Individual
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Provider Name | MARLISSE ROBIN TESTA L.M.H.C
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Gender | Female
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Dates
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Enumeration Date | 09/12/2014
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Last Update Date | 09/12/2014
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Provider Practice Location Address
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Address Line | 4400 N. FEDERAL HIGHWAY SUITE 210-49
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City | BOCA RATON
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State | FL
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Zip | 33431
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Country | US
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Telephone | 954-547-4070
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Fax |
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Provider Business Mailing Address
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Address Line | 21640 NAPA COURT
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City | BOCA RATON
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State | FL
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Zip | 33433
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Country | US
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Telephone | 954-547-4070
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 7587
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License Number State | FL
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