Individual
YULISSA FUNDORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, PSYD
Contact information
Practice address
11529 SW 13TH CT, PEMBROKE PINES, FL 33025-4811
(786) 378-0556
Mailing address
11529 SW 13TH CT, PEMBROKE PINES, FL 33025-4811
(786) 378-0556
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH11719
FL
103TC0700X
Clinical Psychologist
Primary
PY10407
FL
Other
Enumeration date
06/07/2010
Last updated
03/15/2019
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