Provider Demographics
NPI:1710216239
Name:PUMARIEGA, ANN MARIE (LMHC, MCAP)
Entity Type:Individual
Prefix:MRS
First Name:ANN MARIE
Middle Name:
Last Name:PUMARIEGA
Suffix:
Gender:F
Credentials:LMHC, MCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5379 LYONS RD # 439
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-2810
Mailing Address - Country:US
Mailing Address - Phone:954-579-1234
Mailing Address - Fax:
Practice Address - Street 1:4300 N UNIVERSITY DR STE C103
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6243
Practice Address - Country:US
Practice Address - Phone:954-579-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-11
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9961101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health