Provider Demographics
NPI:1699355677
Name:MUSE, LETICIA C (CBHCM)
Entity type:Individual
Prefix:
First Name:LETICIA
Middle Name:C
Last Name:MUSE
Suffix:
Gender:F
Credentials:CBHCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 SW 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2621
Mailing Address - Country:US
Mailing Address - Phone:786-768-5835
Mailing Address - Fax:
Practice Address - Street 1:121 SW 72ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2621
Practice Address - Country:US
Practice Address - Phone:786-768-5835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management