Provider Demographics
NPI:1013380518
Name:QUINTERO, ROSALY (LMHC)
Entity Type:Individual
Prefix:
First Name:ROSALY
Middle Name:
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 1:1140 NE 191ST ST
Mailing Address - Street 2:APT. D-23
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4089
Mailing Address - Country:US
Mailing Address - Phone:305-308-3281
Mailing Address - Fax:
Practice Address - Street 1:5001 SW 74TH CT
Practice Address - Street 2:#104
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4483
Practice Address - Country:US
Practice Address - Phone:305-663-0013
Practice Address - Fax:305-663-8138
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12303101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health