Provider Demographics
NPI:1114136991
Name:PSYCHOTHERAPY & NUTRITION ASSOC
Entity type:Organization
Organization Name:PSYCHOTHERAPY & NUTRITION ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:GARBER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:561-602-0132
Mailing Address - Street 1:5820 N FEDERAL HWY
Mailing Address - Street 2:SUITE A2
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-4003
Mailing Address - Country:US
Mailing Address - Phone:561-602-0132
Mailing Address - Fax:561-353-0699
Practice Address - Street 1:5820 N FEDERAL HWY
Practice Address - Street 2:SUITE A2
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-4003
Practice Address - Country:US
Practice Address - Phone:561-602-0132
Practice Address - Fax:561-353-0699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty