Individual
LISA WUYSDREALLE MELEANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1175 NE 125TH ST, NORTH MIAMI, FL 33161-5015
(954) 793-0599
Mailing address
1055 NW 147TH ST, MIAMI, FL 33168-6953
(954) 793-0599
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
01/17/2023
Last updated
01/17/2023
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