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General NPI Number Information
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NPI Number | 1952918633
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Entity Type | Individual
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Provider Name | JONQUIL CROWOLL
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Gender | Female
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Dates
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Enumeration Date | 09/28/2020
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 2510 NE 3RD AVE
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City | POMPANO BEACH
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State | FL
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Zip | 33064-3845
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Country | US
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Telephone | 754-215-6634
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Fax |
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Provider Business Mailing Address
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Address Line | 3800 NW 120TH WAY
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City | SUNRISE
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State | FL
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Zip | 33323-2638
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Country | US
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Telephone | 754-218-7582
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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 |
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License Number State |
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