Mariela De Lourdes Fantauzzi
Counselor, Mental Health in West Palm Beach, FL. Individual provider (NPI-1).
NPI number1689984809
StatusActive
Last updated in NPPESMar 11, 2019
Details
- NPI
- 1689984809
- Entity type
- Individual (NPI-1)
- Name
- Mariela De Lourdes Fantauzzi
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 21, 2010
- Last updated
- Mar 11, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | MH16747 | FL | Yes |
Practice location
255 Evernia St Apt 1516West Palm Beach, FL 33401-5691
Phone 787-908-0032
Mailing address
255 Evernia St Apt 1516West Palm Beach, FL 33401-5691
Phone 787-908-0032
Other practice locations
7 Urb Las Margaritas
Isabela, PR 00662-2212
Isabela, PR 00662-2212
Phone 787-640-0770
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