Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PY10894 | FL |
N | 103TC0700X | Clinical Psychologist | PY10894 | FL |
Y | 102L00000X | Psychologist | PY10894 | FL |
Y | 103T00000X | Psychologist | PY10894 | FL |
N | 103TA0700X | Adult Development & Aging Psychologist | PY10894 | FL |
N | 103TR0400X | Rehabilitation Psychologist | PY10894 | FL |
NPI | 1093322760 |
---|---|
Provider Name | Giselle Leal |
First Address | Miami, FL 33136-1409 |
Second Address | Miami, FL 33136-1409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2020 |
Last Update Date | 24/03/2021 |