Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PY8909 | FL |
NPI | 1265854467 |
---|---|
Provider Name | Holly Cortella |
First Address | Miami, FL 33150-2004 |
Second Address | Miami, FL 33150-2004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2014 |
Last Update Date | 08/01/2014 |