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Organization

COBIELLA CENTER FOR CHANGE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DEBBIE MULACH (OFFICE MANAGER)
(772) 225-1224
Entity
Organization

Contact information

Practice address
953 NE JENSEN BEACH BLVD, JENSEN BEACH, FL 34957-4705
(772) 225-1224
Mailing address
953 NE JENSEN BEACH BLVD, JENSEN BEACH, FL 34957-4705
(772) 225-1224

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
650238748
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1285723668
IND. NPI #
FL
01
1568551828
IND. NPI #
FL
Enumeration date
12/03/2007
Last updated
01/05/2011
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