Doctor Name: | LORI PANTALEAO |
NPI Number: | 1144623810 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | MH11406 |
Business Practice Address: | 1402 Royal Palm Beach Blvd Ste 102 Royal Palm Beach, FL - 334115001 |
Business Phone Number: | 9548175825 |
Business Fax Number: | 5616935514 |
Mailing Address: | 1402 Royal Palm Beach Blvd Ste 102, ROYAL PALM BEACH |
State: | FL |
Postal Code: | 334115001 |
Phone Number: | 9548175825 |
Fax Number: | 5616935514 |
NPI Enumeration Date: | 10/08/2014 |
NPI Last Update Date: | 10/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH11406 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |