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General NPI Number Information
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NPI Number | 1821821901
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Entity Type | Individual
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Provider Name | GISELLE CORREA GARCIA CBHCM-S
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Gender | Female
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Dates
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Enumeration Date | 08/23/2024
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 4445 W 16TH AVE STE 405
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City | HIALEAH
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State | FL
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Zip | 33012-7803
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Country | US
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Telephone | 786-233-6721
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Fax | 786-703-5179
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Provider Business Mailing Address
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Address Line | 15590 SW 106TH LN APT 1102
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City | MIAMI
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State | FL
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Zip | 33196-3503
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | CBHCMS101238
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License Number State | FL
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