Provider Demographics
NPI:1194050229
Name:HERRERA, MARIA EVELYN (BA)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:EVELYN
Last Name:HERRERA
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12984 63RD LN N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412-2034
Mailing Address - Country:US
Mailing Address - Phone:561-846-1112
Mailing Address - Fax:
Practice Address - Street 1:15818 SW WARFIELD BLVD
Practice Address - Street 2:
Practice Address - City:INDIANTOWN
Practice Address - State:FL
Practice Address - Zip Code:34956-3513
Practice Address - Country:US
Practice Address - Phone:772-597-0411
Practice Address - Fax:772-597-0412
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker