Basic Information
| Provider Information | |||||||||
| NPI: | 1992213250 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAUTNER | ||||||||
| FirstName: | SABRINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9473 NW 11TH ST | ||||||||
| Address2: | |||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333224840 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 N HIATUS RD STE 140 | ||||||||
| Address2: | |||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330263094 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544319838 | ||||||||
| FaxNumber: | 9544337066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2018 | ||||||||
| LastUpdateDate: | 07/24/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 15395 | FL | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.