Provider Demographics
NPI:1326499427
Name:BESTER, AUDREY DANIELLE
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:DANIELLE
Last Name:BESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:DANIELLE
Other - Last Name:BESTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:500 NW 165TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6306
Mailing Address - Country:US
Mailing Address - Phone:786-657-2272
Mailing Address - Fax:
Practice Address - Street 1:500 NW 165TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6306
Practice Address - Country:US
Practice Address - Phone:786-657-2272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health