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General NPI Number Information
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NPI Number | 1457852972
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Entity Type | Individual
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Provider Name | KELLY A DAMBRA LMHC
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Gender | Female
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Dates
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Enumeration Date | 02/21/2018
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 5737 OKEECHOBEE BLVD # 203
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-4366
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Country | US
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Telephone | 561-571-8164
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Fax |
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Provider Business Mailing Address
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Address Line | 914 S LAKE DR
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City | LANTANA
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State | FL
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Zip | 33462-4628
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Country | US
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Telephone | 561-866-9776
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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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