Individual
GEMMA JACQUELINE MENDIETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.S
Contact information
Practice address
5888 SW 27TH ST, MIAMI, FL 33155-3135
(305) 662-4236
Mailing address
5888 SW 27TH ST, MIAMI, FL 33155-3135
(305) 662-4236
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
SS791
FL
Other
Enumeration date
04/21/2009
Last updated
04/21/2009
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