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General NPI Number Information
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NPI Number | 1649728536
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Entity Type | Organization
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Legal Business Name | MOIRA HOWARD
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Dates
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Enumeration Date | 09/20/2016
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 3307 NORTHLAKE BLVD STE B104
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33403-1703
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Country | US
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Telephone | 561-508-9740
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Fax |
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Provider Business Mailing Address
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Address Line | 420 INLET RD
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City | NORTH PALM BEACH
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State | FL
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Zip | 33408-4310
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Country | US
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Telephone | 561-508-9740
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. MOIRA CAITLIN HOWARD
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Credential |
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Telephone | 561-508-9740
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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 | MH12997
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License Number State | FL
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