Individual
MAYTE DE LA MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2332 LUDLAM RD, MIAMI, FL 33155-1846
(305) 740-7557
Mailing address
2225 NE 123RD ST APT 212, NORTH MIAMI, FL 33181-2954
(305) 740-7557
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
04/18/2022
Last updated
04/25/2022
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