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Organization
MDTELEPSYCHOTHERAPY, LLC
Active
Organization
MDTELEPSYCHOTHERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MONIQUE MARTIN (BUSINESS MANAGER)
(561) 727-6196
Entity
Organization
Contact information
Practice address
19500 TURNBERRY WAY PH F, AVENTURA, FL 33180-2539
(954) 961-1500
(561) 450-5230
Mailing address
19500 TURNBERRY WAY PH F, AVENTURA, FL 33180-2539
(786) 877-5800
(561) 450-5230
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MH969
LICENSED MENTAL HEALTH COUNSELOR
FL
Enumeration date
06/04/2020
Last updated
09/08/2020
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