Provider Demographics
NPI:1457800633
Name:MICHELLE MANKOFF, INC
Entity Type:Organization
Organization Name:MICHELLE MANKOFF, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MANKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-573-2222
Mailing Address - Street 1:19071 FOX LANDING DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-5155
Mailing Address - Country:US
Mailing Address - Phone:561-999-0532
Mailing Address - Fax:
Practice Address - Street 1:1700 N DIXIE HWY
Practice Address - Street 2:#103
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1850
Practice Address - Country:US
Practice Address - Phone:561-573-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1787106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty