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General NPI Number Information
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NPI Number | 1457800633
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Entity Type | Organization
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Legal Business Name | MICHELLE MANKOFF, INC
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Dates
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Enumeration Date | 09/28/2016
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Last Update Date | 09/28/2016
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Provider Practice Location Address
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Address Line | 1700 N DIXIE HWY #103
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City | BOCA RATON
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State | FL
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Zip | 33432-1850
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Country | US
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Telephone | 561-573-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 19071 FOX LANDING DR
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City | BOCA RATON
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State | FL
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Zip | 33434-5155
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Country | US
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Telephone | 561-999-0532
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Fax |
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Authorized Official
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Title or Position | LMFT
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Name | MICHELLE L MANKOFF
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Credential |
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Telephone | 561-573-2222
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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 | MT1787
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License Number State | FL
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