Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | MH10008 | FL |
NPI | 1003143694 |
---|---|
Provider Name | Angel M Aguasvivas |
First Address | Coral Springs, FL 33067-2063 |
Second Address | Coral Springs, FL 33067-2063 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2009 |
Last Update Date | 03/11/2009 |