Organization
METAVIDA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAMMY MALLOY PHD, LCSW, CSAT (CHIEF OPERATING OFFICER)
(561) 376-9790
Entity
Organization
Contact information
Practice address
701 OLD DIXIE HWY, TEQUESTA, FL 33469-2493
(561) 523-8887
Mailing address
701 OLD DIXIE HWY, TEQUESTA, FL 33469-2493
(561) 523-8887
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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