Organization
CHANGE MATTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA VERONICA TRIGO LMHC (OWNER)
(954) 854-4390
Entity
Organization
Contact information
Practice address
2893 EXECUTIVE PARK DR STE 119, WESTON, FL 33331-3666
(954) 854-4390
Mailing address
304 INDIAN TRACE ST. #813, WESTON, FL 33326
(954) 854-4390
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH8801
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001010900
—
FL
Enumeration date
05/09/2014
Last updated
05/09/2014
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