Provider Information for 1912248154
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Ms. MARITZA EJENBAUM L.C.S.W.
Other Names:Professional Name:Ms. MARITZA EJENBAUM LCSWSex: Female
NPI: 1912248154
Last Updated: 2023-01-18
Certification Date: 2023-01-18
Certification Date: 2023-01-18
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1912248154 | ||||||||
| Enumeration Date | 2013-03-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 7430 GARY AVE MIAMI BEACH, FL 33141-2510 United States Phone: 305-458-9224 | Fax: | ||||||||
| Primary Practice Address | 333 W 41ST ST SUITE 208-210 MIAMI BEACH, FL 33140-3641 United States Phone: 305-672-8080 | Fax:305-672-0030 | ||||||||
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