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General NPI Number Information
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NPI Number | 1528439874
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Entity Type | Organization
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Legal Business Name | DEBRA GOLDMAN INC.
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Dates
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Enumeration Date | 10/13/2015
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 221 GREENWICH CIR SUITE 100
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City | JUPITER
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State | FL
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Zip | 33458-2890
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Country | US
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Telephone | 561-427-1770
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Fax |
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Provider Business Mailing Address
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Address Line | 395 ASTER ST
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4802
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Country | US
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Telephone | 561-602-8041
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DEBRA JOY GOLDMAN
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Credential | LMHC
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Telephone | 561-602-8041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | MH 2654
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License Number State | FL
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