MEDICARE: NANCY YVONNE PARIS LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	1612	FL

General Provider Information

NPI Number	:	1265753917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY YVONNE PARIS LMFT

Provider Business Mailing Address
First Line	:	3133 N 34TH ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-2625
Country	:	US
Telephone Number	:	954-558-8374
Fax Number	:	866-431-0770

Provider Business Practice Location Address
First Line	:	3133 N. 34TH STREET
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021
Country	:	US
Telephone Number	:	954-558-8374
Fax Number	:	866-431-0770

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2010
Last Update Date	:	06/17/2010

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