Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003158874 |
---|---|
Provider Name | Miss Matilde Zuluaga |
First Address | Miami, FL 33165-2000 |
Second Address | Miami, FL 33165-2000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2013 |
Last Update Date | 07/05/2013 |