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Organization
PALMCOAST THERAPY, INC.
Active
Organization
PALMCOAST THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA CAROLINE MALLEN LCSW (PRESIDENT/CEO)
(954) 309-3449
Entity
Organization
Contact information
Practice address
2598 E SUNRISE BLVD STE 210-A, FT LAUDERDALE, FL 33304-3230
(954) 309-3449
Mailing address
2598 E SUNRISE BLVD STE 210-A, FT LAUDERDALE, FL 33304-3230
(954) 309-3449
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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