Provider Demographics
NPI:1487852141
Name:VEGA, MARCIA (RMFT)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:
Last Name:VEGA
Suffix:
Gender:F
Credentials:RMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 W. FLAGLER ST. SUITE 206
Mailing Address - Street 2:
Mailing Address - City:CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1643
Mailing Address - Country:US
Mailing Address - Phone:305-644-7294
Mailing Address - Fax:305-644-7295
Practice Address - Street 1:4011 W FLAGLER ST STE 206
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1643
Practice Address - Country:US
Practice Address - Phone:305-644-7294
Practice Address - Fax:305-644-7295
Is Sole Proprietor?:No
Enumeration Date:2007-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT65106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist