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General NPI Number Information
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NPI Number | 1538677141
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Entity Type | Individual
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Provider Name | ANTTROY ANTHONY STANLEY
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Gender | Male
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Dates
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Enumeration Date | 01/17/2018
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Last Update Date | 05/19/2020
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Provider Practice Location Address
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Address Line | 1031 IVES DAIRY RD STE 228
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City | MIAMI
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State | FL
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Zip | 33179-2538
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Country | US
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Telephone | 305-528-5914
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Fax | 305-445-5982
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Provider Business Mailing Address
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Address Line | 1491 NE 151ST TER
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-5963
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Country | US
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Telephone | 305-528-0878
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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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