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General NPI Number Information
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NPI Number | 1366861320
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Entity Type | Organization
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Legal Business Name | KENDALL BEHAVIORAL HEALTH CENTER, INC
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Dates
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Enumeration Date | 04/07/2014
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Last Update Date | 04/07/2014
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Provider Practice Location Address
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Address Line | 10621 N KENDALL DR STE 220
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City | MIAMI
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State | FL
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Zip | 33176-1530
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Country | US
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Telephone | 786-402-8282
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Fax | 786-409-5773
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Provider Business Mailing Address
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Address Line | 10621 N. KENDALL DRIVE SUITE 220
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City | MIAMI
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State | FL
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Zip | 33176-8708
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Country | US
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Telephone | 786-402-8282
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Fax | 786-409-5773
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIA VELASCO-QUINTERO
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Credential | LMHC
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Telephone | 786-402-8282
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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 | MH9459
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License Number State | FL
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