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General NPI Number Information
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NPI Number | 1417644949
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Entity Type | Organization
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Legal Business Name | EVERMORE HEALING
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 15211 FINTRY PL
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1424
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Country | US
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Telephone | 786-718-5650
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Fax |
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Provider Business Mailing Address
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Address Line | 15211 FINTRY PL
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1424
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Country | US
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Telephone | 786-718-5650
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Fax |
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR
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Name | REBECCA DOMINGUEZ
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Credential | LMHC
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Telephone | 786-718-5650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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