Provider Demographics
NPI:1891206009
Name:TOLI & FLO CREATIVE STUDIO, LLC
Entity Type:Organization
Organization Name:TOLI & FLO CREATIVE STUDIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ILEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLIBIA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:786-291-6564
Mailing Address - Street 1:7125 BONITA DR APT 402
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-3065
Mailing Address - Country:US
Mailing Address - Phone:786-488-5806
Mailing Address - Fax:
Practice Address - Street 1:8201 SW 24TH ST # 11
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1263
Practice Address - Country:US
Practice Address - Phone:786-291-6564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-14
Last Update Date:2017-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13964101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty