Doctor Name: | ELISE POWELL |
NPI Number: | 1073796983 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | MH 8498 |
Business Practice Address: | 6788 Massachusetts Dr Suite #1 Lantana, FL - 334623836 |
Business Phone Number: | 5616707839 |
Business Fax Number: | |
Mailing Address: | 6788 Massachusetts Dr, Suite #1 LANTANA |
State: | FL |
Postal Code: | 334623836 |
Phone Number: | 5616707839 |
Fax Number: | |
NPI Enumeration Date: | 12/13/2007 |
NPI Last Update Date: | 11/17/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH 8498 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |