Provider Demographics
NPI:1699908939
Name:MANKOFF, MICHELLE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:MANKOFF
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9033 GLADES RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3939
Mailing Address - Country:US
Mailing Address - Phone:561-361-0500
Mailing Address - Fax:
Practice Address - Street 1:9033 GLADES RD
Practice Address - Street 2:SUITE B
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3939
Practice Address - Country:US
Practice Address - Phone:561-361-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 1787106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist