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MS. IVIS M CARRERA VALDES
>> Developmental Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1801161666
Individual Registrant:MS. IVIS M CARRERA VALDES
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
1501 S PINELLAS AVE STE P TARPON SPRINGS, FL 34689-1952 US
Tel: 727-547-3692 Fax: --
Tel: 727-547-3692 Fax: --
Contact information for business:
2005 THRACE ST TAMPA, FL 33605-6353 US
Tel: 813-562-4391 Fax: --
Tel: 813-562-4391 Fax: --
Registration Information:
NPI: 1801161666
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 222Q00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Developmental Therapist | ||
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor | FL | IMH19960 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
