Individual
MS. CAROLE JEAN MABUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAROLE MABUS
Contact information
Practice address
10570 S FEDERAL HWY, PORT ST LUCIE, FL 34952-5606
(772) 380-9973
Mailing address
10570 S FEDERAL HWY, PORT ST LUCIE, FL 34952-5606
(772) 380-9973
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
SA3888
FL
235Z00000X
Speech-Language Pathologist
Primary
SA3888
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010802600
—
FL
Enumeration date
07/29/2013
Last updated
09/03/2014
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