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General NPI Number Information
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NPI Number | 1225586894
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Entity Type | Individual
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Provider Name | LUCY AMELIA FERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 1350 SW 57TH AVE # 313
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City | WEST MIAMI
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State | FL
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Zip | 33144-5775
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Country | US
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Telephone | 305-262-1335
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Fax |
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Provider Business Mailing Address
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Address Line | 11617 NW 62ND TER APT 426
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City | DORAL
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State | FL
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Zip | 33178-2893
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Country | US
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Telephone | 954-470-7317
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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