Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003383464 |
---|---|
Provider Name | Ms. Xiomara Contreras |
First Address | Miami, FL 33125-3377 |
Second Address | Coconut Grove, FL 33133-2740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2018 |
Last Update Date | 24/10/2018 |