Individual
AUDREY M ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
716 SW 122ND AVE, PEMBROKE PINES, FL 33025-5950
(954) 605-1525
Mailing address
716 SW 122ND AVE, PEMBROKE PINES, FL 33025-5950
(954) 605-1525
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1922
FL
Other
Enumeration date
06/13/2023
Last updated
06/13/2023
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