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General NPI Number Information
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NPI Number | 1730782954
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Entity Type | Organization
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Legal Business Name | ON THE RIGHT PATH, LLC
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 11/19/2020
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Provider Practice Location Address
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Address Line | 3095 N COURSE DR APT 305
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3370
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Country | US
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Telephone | 703-577-4989
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Fax | 954-366-3539
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Provider Business Mailing Address
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Address Line | 3095 N COURSE DR APT 305
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3370
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Country | US
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Telephone | 703-577-4989
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Fax | 954-366-3539
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Authorized Official
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Title or Position | PROFESSIONAL COUNSELOR
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Name | MR. GEORGE POLK
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Credential | LMHC, LPC
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Telephone | 703-577-4989
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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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