Provider Demographics
NPI:1275173924
Name:BOUIE, PEARL ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:PEARL
Middle Name:ELIZABETH
Last Name:BOUIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 W OAKLAND PARK BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1348
Mailing Address - Country:US
Mailing Address - Phone:954-486-8878
Mailing Address - Fax:888-516-7046
Practice Address - Street 1:2701 W OAKLAND PARK BLVD STE 101
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33311-1348
Practice Address - Country:US
Practice Address - Phone:954-486-8878
Practice Address - Fax:888-516-7046
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty