Provider Demographics
NPI:1194039503
Name:CAMERO, MARIOLA (MSED, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:MARIOLA
Middle Name:
Last Name:CAMERO
Suffix:
Gender:F
Credentials:MSED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1444 BARACOA AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1908
Mailing Address - Country:US
Mailing Address - Phone:786-208-4730
Mailing Address - Fax:
Practice Address - Street 1:7875 NW 12TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1836
Practice Address - Country:US
Practice Address - Phone:786-208-4730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10239101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health