| Doctor Name: | MARIAM BACH |
| NPI Number: | 1245694504 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MH9051 |
| License Number: | MH9051 |
| Business Practice Address: | 1926 Ne 154th Street North Miami Beach, FL - 331626022 |
| Business Phone Number: | 3059492924 |
| Business Fax Number: | 3059499038 |
| Mailing Address: | 1926 Ne 154th Street, NORTH MIAMI BEACH |
| State: | FL |
| Postal Code: | 331626022 |
| Phone Number: | 3059492924 |
| Fax Number: | 3059499038 |
| NPI Enumeration Date: | 04/12/2016 |
| NPI Last Update Date: | 04/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | MH9051 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |