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General NPI Number Information
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NPI Number | 1194155465
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Entity Type | Individual
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Provider Name | DIONE DE POOTER LMFT, MCAP
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Gender | Female
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Dates
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Enumeration Date | 11/22/2013
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 10031 PINES BLVD STE 249
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6180
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Country | US
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Telephone | 954-367-9149
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Fax | 954-416-7755
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Provider Business Mailing Address
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Address Line | 10031 PINES BLVD STE 249
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6180
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Country | US
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Telephone | 954-367-9149
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 5910
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT2570
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License Number State | FL
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