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Marly Ayala-icaza, MH14786
Mental Health Counselor in Bradenton, Florida
NPI 1821412230

Marly Ayala-icaza is a Mental Health Counselor based in Bradenton, FL and is specialized in Mental Health. Marly Ayala-icaza practices in Bradenton, FL and has the professional credentials of MH14786. The NPI Number for Marly Ayala-icaza is 1821412230 and holds a License No. IMH2387 (Florida).

The current practice location address for Marly Ayala-icaza is 3500 El Conquistador Pkwy Apt 259, Bradenton, FL and can be reached out via phone at 954-806-3698.

Location: 3500 El Conquistador Pkwy Apt 259, Bradenton, FL, 34210-3819
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821412230
Provider Name
Marly Ayala-icaza
Credential
MH14786
Provider Entity Type
Individual
Gender
Female
Address
3500 El Conquistador Pkwy Apt 259, Bradenton, FL, 34210-3819
Phone Number
954-806-3698
Fax Number
Provider Enumeration Date
02/06/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3500 El Conquistador Pkwy Apt 259
City
Bradenton
State
Florida
Zip
34210-3819
Phone Number
954-806-3698
Fax Number
person
Provider Business Mailing Address Details
Address
3500 El Conquistador Pkwy Apt 259
City
Bradenton
State
Florida
Zip
34210-3819
Phone Number
954-806-3698
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
IMH2387 (Florida)
Definition
Definition to come...
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