Individual
JULIE M BASULTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., LMFT
Contact information
Practice address
18441 NW 2ND AVE, SUITE 500, MIAMI GARDENS, FL 33169-4517
(305) 249-0521
(305) 249-0523
Mailing address
18441 NW 2ND AVE, SUITE 500, MIAMI GARDENS, FL 33169-4517
(305) 249-0521
(305) 249-0523
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT 2348
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
12/03/2009
Last updated
12/03/2009
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