Provider Demographics
NPI:1861842833
Name:PASHALIDIS, SULTANA MARIA (MA LMFT)
Entity Type:Individual
Prefix:
First Name:SULTANA
Middle Name:MARIA
Last Name:PASHALIDIS
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 E SUNRISE BLVD
Mailing Address - Street 2:SUITE 517
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-1433
Mailing Address - Country:US
Mailing Address - Phone:954-945-0288
Mailing Address - Fax:
Practice Address - Street 1:1975 E SUNRISE BLVD
Practice Address - Street 2:SUITE 517
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-1433
Practice Address - Country:US
Practice Address - Phone:954-945-0288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3191106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist