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General NPI Number Information
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NPI Number | 1255080156
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Entity Type | Individual
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Provider Name | ELANA MENENDEZ RMFTI
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Gender | Female
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Dates
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Enumeration Date | 03/20/2022
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Last Update Date | 11/08/2024
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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 | 33331-3657
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Country | US
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Telephone | 754-246-5681
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Fax |
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Provider Business Mailing Address
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Address Line | 12801 TROTTER BLVD
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City | DAVIE
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State | FL
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Zip | 33330-4314
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Country | US
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Telephone | 954-706-7600
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-21-191466
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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 | IMT4242
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License Number State | FL
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