MEDICARE: MRS. LEAH GUZMAN ATR-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	221700000X	Art Therapist

General Provider Information

NPI Number	:	1922498385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LEAH GUZMAN ATR-BC

Provider Business Mailing Address
First Line	:	9845 SW 123RD TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-4935
Country	:	US
Telephone Number	:	305-721-7480
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 S DIXIE HWY
Second Line	:	SUITE 2000
City	:	COCONUT GROVE
State	:	FL
Zip	:	33133-2456
Country	:	US
Telephone Number	:	305-721-7480
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2015
Last Update Date	:	01/23/2015

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