Michelle Mantilla, Psy.D
Psychologist, Clinical in Hialeah, FL. Individual provider (NPI-1).
NPI number1568898807
StatusActive
Last updated in NPPESMar 22, 2017
Details
- NPI
- 1568898807
- Entity type
- Individual (NPI-1)
- Name
- Michelle Mantilla
- Credential
- Psy.D
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 18, 2013
- Last updated
- Mar 22, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | PY8859 | FL | Yes |
Practice location
4175 W 20th AveHialeah, FL 33012-5874
Phone 305-825-0300
Mailing address
14132 Sw 52nd LnMiramar, FL 33027-5981
Phone 786-863-1948
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