Doctor Name: | MR. JOSEPH MIRABELLA |
NPI Number: | 1538447511 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHC |
License Number: | MH 10646 |
Business Practice Address: | 1948 Sheffield Ave Marco Island, FL - 341456703 |
Business Phone Number: | 2393892292 |
Business Fax Number: | |
Mailing Address: | 1948 Sheffield Ave, MARCO ISLAND |
State: | FL |
Postal Code: | 341456703 |
Phone Number: | 2393892292 |
Fax Number: | |
NPI Enumeration Date: | 07/25/2011 |
NPI Last Update Date: | 07/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH 10646 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |