Provider Demographics
NPI:1124678958
Name:TORRES CHAVIANO, IVONNE (RBT)
Entity type:Individual
Prefix:
First Name:IVONNE
Middle Name:
Last Name:TORRES CHAVIANO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 SE 9TH AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-5743
Mailing Address - Country:US
Mailing Address - Phone:786-537-9791
Mailing Address - Fax:
Practice Address - Street 1:823 SE 9TH AVE APT 1A
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5743
Practice Address - Country:US
Practice Address - Phone:786-537-9791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician