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NPI Code Detail

MEDICARE: MS. TRACY MWENDE OREGO MA

MEDICARE:  MS. TRACY MWENDE OREGO  MA
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1811238892
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TRACY MWENDE OREGO MA
Provider Business Mailing Address
First Line : 1925 S PERIMETER ROAD SUITE 120
Second Line :
City : FORTLAUDERDALE
State : FL
Zip : 33309
Country : US
Telephone Number : 954-958-3527
Fax Number : 954-958-3529
Provider Business Practice Location Address
First Line : 1925 S PERIMETER RD STE 120
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-7123
Country : US
Telephone Number : 954-958-3527
Fax Number : 954-958-3529
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2013
Last Update Date : 03/15/2013

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Directions to “ MS. TRACY MWENDE OREGO MA” Practice Location

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