Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | IMH 5766 | FL |
NPI | 1003056086 |
---|---|
Provider Name | Renata M. Cerveira |
First Address | Longwood, FL 32750-6149 |
Second Address | Longwood, FL 32750-6149 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2009 |
Last Update Date | 03/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
IMH 5766 | REGISTERED MENTAL HEALTH COUNSELOR INTERN (01) | FL |