Individual
ANDREA MANTILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
4330 W BROWARD BLVD STE I, PLANTATION, FL 33317-3753
(954) 372-0423
Mailing address
45 SW 9TH ST APT 3902, MIAMI, FL 33130-3986
(954) 804-6480
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
19064
FL
Other
Enumeration date
05/26/2022
Last updated
05/26/2022
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