Provider Demographics
NPI:1376081869
Name:AKE, MAUREEN HELEN
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:HELEN
Last Name:AKE
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 1:555 COLORADO AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3013
Mailing Address - Country:US
Mailing Address - Phone:772-353-1692
Mailing Address - Fax:
Practice Address - Street 1:555 COLORADO AVE
Practice Address - Street 2:SUITE111
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3013
Practice Address - Country:US
Practice Address - Phone:772-353-1692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT2386106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist