Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | MH 7985 | FL |
NPI | 1003074360 |
---|---|
Provider Name | Mrs. Jessica Mushlin |
First Address | Boca Raton, FL 33428-4722 |
Second Address | Boca Raton, FL 33428-4722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2008 |
Last Update Date | 22/05/2008 |