Provider Demographics
NPI:1265035679
Name:QUINTERO, MARIA CAMILA (LMHC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CAMILA
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6055 NW 104TH AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4867
Mailing Address - Country:US
Mailing Address - Phone:786-476-5155
Mailing Address - Fax:
Practice Address - Street 1:6055 NW 104TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4867
Practice Address - Country:US
Practice Address - Phone:786-476-5155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18461101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health