Provider Demographics
NPI:1063253144
Name:HEALHER JACQUELINE & ASSOCIATES THERAPEUTIC SERVICES LLC
Entity type:Organization
Organization Name:HEALHER JACQUELINE & ASSOCIATES THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:305-910-4918
Mailing Address - Street 1:17122 NW 9TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5235
Mailing Address - Country:US
Mailing Address - Phone:305-910-4918
Mailing Address - Fax:
Practice Address - Street 1:6625 MIAMI LAKES DR STE 501
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2708
Practice Address - Country:US
Practice Address - Phone:866-522-5430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health