Organization
BLUE MOON SENIOR COUNSELING, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE DONOHUE LCSW (OWNER)
(855) 241-7160
Entity
Organization
Contact information
Practice address
900 NE 18TH AVE APT 1207, FORT LAUDERDALE, FL 33304-3054
(630) 844-7077
Mailing address
900 NE 18TH AVE APT 1207, FORT LAUDERDALE, FL 33304-3054
(630) 844-7077
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SW10454
FL
Other
Enumeration date
08/17/2012
Last updated
08/17/2012
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