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General NPI Number Information
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NPI Number | 1720950124
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Entity Type | Organization
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Legal Business Name | IMMACULATE RESULTS LLC
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 5555 NW 95TH AVE
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City | SUNRISE
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State | FL
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Zip | 33351-4320
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Country | US
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Telephone | 954-478-7809
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Fax |
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Provider Business Mailing Address
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Address Line | 8551 NW 80TH ST
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City | TAMARAC
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State | FL
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Zip | 33321-1664
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Country | US
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Telephone | 954-478-7809
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. KICIA DANIEL
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Credential |
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Telephone | 954-478-7809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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