Individual
SANDRA IBANEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHC
Contact information
Practice address
1601 NW 12TH AVE, MIAMI, FL 33136-1005
(786) 208-5327
Mailing address
16057 SW 85TH ST, MIAMI, FL 33193-3078
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
222Q00000X
Developmental Therapist
Primary
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
08/09/2016
Last updated
09/19/2017
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