Organization
AC ASPIRE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WYNETTE B GREEN LMFT (PROGRAM DIRECTOR)
(305) 244-8763
Entity
Organization
Contact information
Practice address
2425 E COMMERCIAL BLVD STE 400, FORT LAUDERDALE, FL 33308-4029
(305) 244-8763
Mailing address
4584 SW 113TH AVENUE BLDG 7 APT 312, PEMBROKE PINES, FL 33025
(305) 244-8763
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT2794
FL
Other
Enumeration date
02/26/2016
Last updated
02/26/2016
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