Individual
MS. PHYLLIS RENA MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2881 E OAKLAND PARK BLVD, STE.317, FORT LAUDERDALE, FL 33306-1813
(954) 315-1752
Mailing address
809 NE 23RD DR, APT. 4, WILTON MANORS, FL 33305-1277
(954) 513-7275
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
05/20/2010
Last updated
06/27/2011
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