Basic Information
| Provider Information | |||||||||
| NPI: | 1952046336 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WESTERN | ||||||||
| FirstName: | VERONICA | ||||||||
| MiddleName: | MIGUEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 230 174TH ST APT 918 | ||||||||
| Address2: | |||||||||
| City: | SUNNY ISLES BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331603327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3053352533 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2925 AVENTURA BLVD STE 300 | ||||||||
| Address2: | |||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331803109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059361002 | ||||||||
| FaxNumber: | 3059361022 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2022 | ||||||||
| LastUpdateDate: | 05/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.