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NPI 1891068136

NPI 1891068136 : ANYA MONTEFIORE L.M.H.C. : JACKSONVILLE, FL

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General NPI Number Information
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    NPI Number           |    1891068136
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    Entity Type          |    Individual 
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    Provider Name        |    ANYA MONTEFIORE L.M.H.C.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/16/2012
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    Last Update Date     |    02/16/2012
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Provider Practice Location Address
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    Address Line         |    1734 HIRAM ST 
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32209-6105
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    Country              |    US
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    Telephone            |    305-297-3705
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    412 WALDEN LN 
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    City                 |    SAVANNAH
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    State                |    GA
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    Zip                  |    31405-8408
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    Country              |    US
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    Telephone            |    305-297-3705
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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       |    MH2866
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    License Number State |    FL
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