MEDICARE: MISS PARVEEN KAUR MS

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		FL

General Provider Information

NPI Number	:	1326362617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS PARVEEN KAUR MS

Provider Business Mailing Address
First Line	:	1530 VICTORY PALM DR
Second Line	:
City	:	EDGEWATER
State	:	FL
Zip	:	32132-2424
Country	:	US
Telephone Number	:	386-576-4810
Fax Number	:

Provider Business Practice Location Address
First Line	:	259 BILL FRANCE BLVD
Second Line	:	SUITE # 200
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-1316
Country	:	US
Telephone Number	:	386-576-4810
Fax Number	:

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

Provider Enumeration Date	:	03/16/2010
Last Update Date	:	05/04/2015

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