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General NPI Number Information
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NPI Number | 1942079603
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Entity Type | Individual
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Provider Name | BROOKE WHITFIELD-FATTOVICH
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Gender | Female
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Dates
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Enumeration Date | 12/21/2023
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 24 VIA FLORESTA DR
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City | BOCA RATON
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State | FL
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Zip | 33487-1583
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Country | US
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Telephone | 954-849-2513
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Fax |
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Provider Business Mailing Address
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Address Line | 24 VIA FLORESTA DR
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City | BOCA RATON
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State | FL
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Zip | 33487-1583
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Country | US
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Telephone | 954-849-2513
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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 | 22271
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License Number State | FL
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