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General NPI Number Information
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NPI Number | 1366127987
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Entity Type | Organization
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Legal Business Name | HIBISCUS PSYCHOTHERAPY PLLC
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 2915 BISCAYNE BLVD STE 300
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City | MIAMI
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State | FL
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Zip | 33137-4197
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Country | US
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Telephone | 312-880-9656
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Fax |
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Provider Business Mailing Address
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Address Line | 2915 BISCAYNE BLVD STE 300
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City | MIAMI
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State | FL
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Zip | 33137-4197
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Country | US
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Telephone | 312-880-9656
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | APOLLONIA WENTING KANG AITSAHALIA
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Credential | LMHC
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Telephone | 312-880-9656
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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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