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Individual

AIDA MARIA CUSTODE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
440 SAWGRASS CORPORATE PKWY STE 106, SUNRISE, FL 33325-6236
(954) 745-1112
Mailing address
9516 SW 117TH AVE, MIAMI, FL 33186-2122
(305) 725-8599

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
FL

Other

Enumeration date
03/06/2012
Last updated
03/06/2012
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