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Organization
COLLECTIVE SELF LLC
Active
Organization
COLLECTIVE SELF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENEVERE ABRIEL (CEO)
(954) 240-0884
Entity
Organization
Contact information
Practice address
4400 W SAMPLE RD STE 112, COCONUT CREEK, FL 33073-3457
(954) 240-0884
(505) 438-1820
Mailing address
5379 LYONS RD # 172, COCONUT CREEK, FL 33073-2810
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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