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General NPI Number Information
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NPI Number | 1871744284
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Entity Type | Organization
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Legal Business Name | CPMH PROFESSIONAL HEALTH SERVICES
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Dates
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Enumeration Date | 10/03/2008
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Last Update Date | 10/03/2008
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Provider Practice Location Address
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Address Line | 2845 SW 176TH TER
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City | MIRAMAR
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State | FL
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Zip | 33029-5556
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Country | US
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Telephone | 954-895-1465
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Fax | 954-433-3236
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Provider Business Mailing Address
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Address Line | 2845 SW 176TH TER
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City | MIRAMAR
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State | FL
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Zip | 33029-5556
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Country | US
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Telephone | 954-895-1465
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Fax | 954-433-3236
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. CAROL CHOUTE PIERRE
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Credential | ARNP
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Telephone | 954-895-1465
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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 | 2679592
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License Number State | FL
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