Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MA40066 | FL |
NPI | 1740668029 |
---|---|
Provider Name | Debra Mace |
First Address | West Palm Beach, FL 33418-7316 |
Second Address | West Palm Beach, FL 33418-7316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2015 |
Last Update Date | 07/05/2015 |