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General NPI Number Information
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NPI Number | 1396384814
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Entity Type | Organization
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Legal Business Name | MY MENTAL HEALTH LLC
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Dates
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Enumeration Date | 01/01/2020
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 4995 NW 72ND AVE STE 204
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City | MIAMI
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State | FL
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Zip | 33166-5643
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Country | US
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Telephone | 347-366-6815
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Fax |
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Provider Business Mailing Address
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Address Line | 4995 NW 72ND AVE STE 204
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City | MIAMI
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State | FL
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Zip | 33166-5643
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Country | US
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Telephone | 347-366-6815
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MABEL Y DUARTE
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Credential |
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Telephone | 347-366-6815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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