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General NPI Number Information
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NPI Number | 1982140471
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Entity Type | Organization
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Legal Business Name | MARCIA GONCALVES TERLEP INC.
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Dates
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Enumeration Date | 01/09/2017
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Last Update Date | 01/28/2017
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Provider Practice Location Address
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Address Line | 2324 S CONGRESS AVE STE 1F
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City | PALM SPRINGS
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State | FL
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Zip | 33406-7667
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Country | US
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Telephone | 561-308-8191
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Fax | 561-439-3707
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Provider Business Mailing Address
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Address Line | 1354 WILLOW RD
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-5066
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Country | US
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Telephone | 561-308-8191
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Fax | 561-439-3707
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARCIA A. GONCALVES -TERLEP
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Credential | M.A.
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Telephone | 561-308-8191
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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 | MH 12284
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License Number State | FL
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