| Broken Cycle | |
|
2825 Sw 14th St Fort Lauderdale FL 33312-3906 | |
| (954) 851-4640 | |
| Not Available |
| Full Name | Broken Cycle |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2825 Sw 14th St, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Jessica K. Coutain (OWNER) |
| Authorized Official Contact | 9548514640 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broken Cycle 2825 Sw 14th St Fort Lauderdale FL 33312-3906 Ph: (954) 851-4640 | Broken Cycle 2825 Sw 14th St Fort Lauderdale FL 33312-3906 Ph: (954) 851-4640 |
| NPI Number | 1649621962 |
|---|---|
| Provider Enumeration Date | 06/28/2016 |
| Last Update Date | 06/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649621962 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH 14023 (Florida) | Primary |
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