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General NPI Number Information
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NPI Number | 1861328783
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Entity Type | Organization
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Legal Business Name | EMBODY HEALTH PSYCHOLOGY PA
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Dates
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Enumeration Date | 06/18/2026
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Last Update Date | 06/18/2026
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Provider Practice Location Address
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Address Line | 3580 MYSTIC POINTE DR STE 115
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City | AVENTURA
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State | FL
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Zip | 33180-2554
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Country | US
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Telephone | 305-482-3808
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Fax |
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Provider Business Mailing Address
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Address Line | 3580 MYSTIC POINTE DR STE 115
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City | AVENTURA
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State | FL
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Zip | 33180-2554
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Country | US
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Telephone | 305-482-3808
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. MARIAH ALISE MELISSA STREETER
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Credential | PSYD
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Telephone | 305-482-3808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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