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General NPI Number Information
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NPI Number | 1659473049
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Entity Type | Individual
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Provider Name | KATIA QUEVEDO PY
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Gender | Female
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 2103 CORAL WAY STE 405
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City | MIAMI
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State | FL
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Zip | 33145-2630
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Country | US
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Telephone | 305-445-3222
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Fax |
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Provider Business Mailing Address
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Address Line | 13205 NW 7TH LN
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City | MIAMI
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State | FL
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Zip | 33182-2282
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Country | US
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Telephone | 305-798-7317
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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 | MH11168
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY11260
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License Number State | FL
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