Provider Demographics
NPI:1346761525
Name:MANFRE, JULIA ALLNUTT (LMHC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ALLNUTT
Last Name:MANFRE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 NW 13TH ST STE 214-12
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-1641
Mailing Address - Country:US
Mailing Address - Phone:561-424-7270
Mailing Address - Fax:
Practice Address - Street 1:123 NW 13TH ST STE 214
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1641
Practice Address - Country:US
Practice Address - Phone:561-424-7270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13756101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health