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NPI 1326935255

NPI 1326935255 : EDITH GISSELLE GONZALEZ RMHCI : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1326935255
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    Entity Type          |    Individual 
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    Provider Name        |    EDITH GISSELLE GONZALEZ RMHCI
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    Gender               |     
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Dates
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    Enumeration Date     |    06/23/2025
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    Last Update Date     |    06/23/2025
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Provider Practice Location Address
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    Address Line         |    1401 SW 1ST ST STE 209 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33135-2261
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    Country              |    US
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    Telephone            |    786-361-7787
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    Fax                  |    305-902-3885
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Provider Business Mailing Address
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    Address Line         |    8004 NW 154TH ST 
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    City                 |    MIAMI LAKES
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    State                |    FL
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    Zip                  |    33016-5814
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    Country              |    US
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    Telephone            |    305-512-3646
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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       |    IMH25643
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    License Number State |    FL
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