Provider Demographics
NPI:1639650773
Name:EXPEDITIONS IN MOTHERHOOD, INC
Entity Type:Organization
Organization Name:EXPEDITIONS IN MOTHERHOOD, INC
Other - Org Name:EXPEDITIONS IN MOTHERHOOD, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMHC
Authorized Official - Phone:954-884-0050
Mailing Address - Street 1:3325 HOLLYWOOD BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6937
Mailing Address - Country:US
Mailing Address - Phone:954-884-0050
Mailing Address - Fax:
Practice Address - Street 1:3325 HOLLYWOOD BLVD STE 304
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6937
Practice Address - Country:US
Practice Address - Phone:954-884-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15012101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty