Individual
DR. ELIZABETH DOMINIQUE MESA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
19000 SW 377TH ST, FLORIDA CITY, FL 33034-6409
(305) 242-1848
Mailing address
4945 SW 140TH CT, MIAMI, FL 33175-4813
(305) 527-6006
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY7372
FL
Other
Enumeration date
05/13/2007
Last updated
07/08/2007
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