Provider Demographics
NPI:1578679502
Name:HUESO, SARA (MA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:
Last Name:HUESO
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:HUESO MONIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LMHC
Mailing Address - Street 1:10142 NW 3RD CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7048
Mailing Address - Country:US
Mailing Address - Phone:954-474-2608
Mailing Address - Fax:
Practice Address - Street 1:2771 EXECUTIVE PARK DR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3642
Practice Address - Country:US
Practice Address - Phone:954-385-4696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7887101YM0800X
MA5098101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health