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General NPI Number Information
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NPI Number | 1780825190
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Entity Type | Individual
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Provider Name | JACQUELINE Y PARDILLO LMHC
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Gender | Female
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Dates
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Enumeration Date | 03/13/2009
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 1200 N FEDERAL HWY STE 200
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City | BOCA RATON
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State | FL
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Zip | 33432-2813
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Country | US
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Telephone | 305-721-3128
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Fax |
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Provider Business Mailing Address
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Address Line | 9796 NW 51ST TER
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City | DORAL
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State | FL
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Zip | 33178-1910
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Country | US
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Telephone | 786-229-6589
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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 | MH9761
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License Number State | FL
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