MEDICARE: CHANTAL MINIET RMHC

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	101YM0800X	Mental Health Counselor	19930	FL

General Provider Information

NPI Number	:	1295493294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANTAL MINIET RMHC

Provider Business Mailing Address
First Line	:	3936 HAVERFORD AVE APT 4
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-2812
Country	:	US
Telephone Number	:	305-610-7913
Fax Number	:

Provider Business Practice Location Address
First Line	:	3355 W 68TH ST APT 159
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-1743
Country	:	US
Telephone Number	:	305-610-7913
Fax Number	:

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

Provider Enumeration Date	:	12/07/2021
Last Update Date	:	12/07/2021

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Directions to “ CHANTAL MINIET RMHC” Practice Location

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