Provider Demographics
NPI:1134882343
Name:NEMIROFF, JOANNE
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:NEMIROFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 N COURSE DR APT 607
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-3333
Mailing Address - Country:US
Mailing Address - Phone:305-318-8100
Mailing Address - Fax:
Practice Address - Street 1:3010 N COURSE DR APT 607
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-3333
Practice Address - Country:US
Practice Address - Phone:305-318-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS044103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool