Provider Demographics
NPI:1235572884
Name:PUENTES, MARIA TERESA (BCBA,LMHC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:TERESA
Last Name:PUENTES
Suffix:
Gender:
Credentials:BCBA,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4302 HOLLYWOOD BLVD # 177
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6635
Mailing Address - Country:US
Mailing Address - Phone:786-438-8188
Mailing Address - Fax:407-960-2634
Practice Address - Street 1:498 PALM SPRINGS DR # 100-113
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-7829
Practice Address - Country:US
Practice Address - Phone:786-274-3549
Practice Address - Fax:407-960-2634
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-14
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-56305103K00000X
FLMH13032101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health