Provider Demographics
NPI:1235612490
Name:MEJIA, MARIA ANGELICA (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ANGELICA
Last Name:MEJIA
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 174TH ST APT L03
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3324
Mailing Address - Country:US
Mailing Address - Phone:305-742-4167
Mailing Address - Fax:
Practice Address - Street 1:230 174TH ST APT L03
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-3324
Practice Address - Country:US
Practice Address - Phone:305-742-4167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3181101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty