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General NPI Number Information
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NPI Number | 1316548365
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Entity Type | Organization
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Legal Business Name | NEW LEAF THERAPY, LLC
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 11/05/2020
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Provider Practice Location Address
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Address Line | 2331 NW 69TH CT
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-1438
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Country | US
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Telephone | 954-801-2863
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Fax |
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Provider Business Mailing Address
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Address Line | 2637 E ATLANTIC BLVD # 1236
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City | POMPANO BEACH
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State | FL
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Zip | 33062-4939
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Country | US
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Telephone | 954-801-2863
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MELISSA VALENTINA
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Credential | PHD, LMFT
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Telephone | 954-801-2863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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