Individual
ANDREA WANZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
530 NW 183RD ST, MIAMI GARDENS, FL 33169-4468
(305) 654-7251
(305) 647-0203
Mailing address
1031 IVES DAIRY RD STE 228, MIAMI, FL 33179-2538
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH14491
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MH14491
STATE LICENSE
FL
Enumeration date
07/07/2017
Last updated
11/07/2018
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