Basic Information
| Provider Information | |||||||||
| NPI: | 1679603567 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARREAZA | ||||||||
| FirstName: | MARISELA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MISS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5900 SW 56TH TER | ||||||||
| Address2: | |||||||||
| City: | SOUTH MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331432270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3057407252 | ||||||||
| FaxNumber: | 3055979495 | ||||||||
| Practice Location | |||||||||
| Address1: | 7392 NW 35TH TER | ||||||||
| Address2: | SUITES 201 AND 202 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331221271 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055979494 | ||||||||
| FaxNumber: | 3055979495 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | MH 5923 | FL | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.