Provider Demographics
NPI:1477805885
Name:AXIOM HEALTH, LLC
Entity Type:Organization
Organization Name:AXIOM HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAVIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:561-262-6048
Mailing Address - Street 1:531 W KALMIA DR
Mailing Address - Street 2:11
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-2272
Mailing Address - Country:US
Mailing Address - Phone:561-262-6048
Mailing Address - Fax:
Practice Address - Street 1:221 GREENWICH CIR
Practice Address - Street 2:111
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2890
Practice Address - Country:US
Practice Address - Phone:561-262-6048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8634103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty