Provider Demographics
NPI:1134934342
Name:AVILA, MARIA ANTONIA (LMFT, MCAP)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ANTONIA
Last Name:AVILA
Suffix:
Gender:F
Credentials:LMFT, MCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 S UNIVERSITY DR # 517
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3817
Mailing Address - Country:US
Mailing Address - Phone:305-498-9324
Mailing Address - Fax:
Practice Address - Street 1:4611 S UNIVERSITY DR # 517
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3817
Practice Address - Country:US
Practice Address - Phone:305-498-9324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1398101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health