Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist |
NPI | 1013178607 |
---|---|
Provider Name | Jused Graciela Melian |
First Address | Sunrise, FL 33325-6244 |
Second Address | Sunrise, FL 33325-6244 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2008 |
Last Update Date | 17/06/2008 |