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General NPI Number Information
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NPI Number | 1235808536
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Entity Type | Individual
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Provider Name | KARINA JOCILE NECIOSUP MACP
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Gender | Female
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Dates
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Enumeration Date | 09/09/2021
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Last Update Date | 09/09/2021
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Provider Practice Location Address
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Address Line | 2731 EXECUTIVE PARK DR.
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City | WESTON
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State | FL
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Zip | 33331
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Country | US
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Telephone | 754-246-5618
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Fax |
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Provider Business Mailing Address
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Address Line | 17322 SW 18TH ST
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City | MIRAMAR
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State | FL
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Zip | 33029-5529
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Country | US
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Telephone | 786-274-0819
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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 |
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License Number State |
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