MS. Mirella Carla Ezeta, PSY.D
NPI #1285941690 in Ft Lauderdale, Florida
Provider Information
- NPI Number
- 1285941690
- Entity Type
- Individual
- Name
- MS. Mirella Carla Ezeta, PSY.D
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Mental Health
- Credential
- PSY.D
- Enumeration Date
- Sep 7, 2010
- Last Updated
- Sep 8, 2010
Practice Location
- Address
- 3521 W BROWARD BLVD
- City
- Ft Lauderdale
- State
- Florida
- ZIP Code
- 33312-1048
- Phone
- (954) 587-1008
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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