Individual
MARY LOUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2856 TENNIS CLUB DR APT 200, WEST PALM BEACH, FL 33417-2945
(561) 306-1281
Mailing address
2856 TENNIS CLUB DR APT 200, WEST PALM BEACH, FL 33417-2945
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
5188867
FL
Other
Enumeration date
12/04/2017
Last updated
12/04/2017
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