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General NPI Number Information
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NPI Number | 1609151497
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Entity Type | Organization
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Legal Business Name | FAMILY MATTERS COUNSELING P.A.
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Dates
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Enumeration Date | 10/12/2011
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Last Update Date | 10/12/2011
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Provider Practice Location Address
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Address Line | 2501 E COMMERCIAL BLVD SUITE 211
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4131
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Country | US
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Telephone | 954-614-7371
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 E COMMERCIAL BLVD SUITE 211
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4131
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Country | US
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Telephone | 954-614-7371
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Fax |
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Authorized Official
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Title or Position | CEO/CLINICAL DIRECTOR
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Name | MS. FANYA JABOUIN-MONNAY
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Credential | LMFT
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Telephone | 954-614-7371
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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 | MT2501
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License Number State | FL
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