Individual
MARIELA INES MICCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6160 SW 195TH AVE, FORT LAUDERDALE, FL 33332-3391
(786) 348-6957
Mailing address
6160 SW 195TH AVE, FORT LAUDERDALE, FL 33332-3391
(786) 348-6957
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
224Z00000X
Occupational Therapy Assistant
OTA13468
FL
Other
Enumeration date
08/01/2014
Last updated
07/10/2023
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