| Doctor Name: | EDLYNE THELUSMA |
| NPI Number: | 1134370869 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMHC |
| License Number: | IMH6494 |
| Business Practice Address: | 4720 N State Road 7 Lauderdale Lakes, FL - 333195860 |
| Business Phone Number: | 9544630911 |
| Business Fax Number: | |
| Mailing Address: | 4740 N State Road 7, Suite 201 LAUDERDALE LAKES |
| State: | FL |
| Postal Code: | 333195839 |
| Phone Number: | 9544864005 |
| Fax Number: | |
| NPI Enumeration Date: | 09/30/2008 |
| NPI Last Update Date: | 07/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | IMH6494 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |