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General NPI Number Information
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NPI Number | 1356079560
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Entity Type | Organization
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Legal Business Name | FOOD FOR HEART THERAPY PLLC
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 08/15/2022
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Provider Practice Location Address
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Address Line | 332 S MICHIGAN AVE STE 121 #5590
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City | CHICAGO
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State | IL
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Zip | 60604-4302
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Country | US
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Telephone | 312-912-1033
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Fax |
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Provider Business Mailing Address
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Address Line | 732 82ND ST APT 4
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City | MIAMI BEACH
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State | FL
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Zip | 33141-1377
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Country | US
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Telephone | 312-912-1033
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MICHELLE AHMED
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Credential | MS, LMFT
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Telephone | 312-912-1033
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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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