Provider Demographics
NPI:1215333828
Name:LIBRA, VALENTINA (PHD)
Entity type:Individual
Prefix:DR
First Name:VALENTINA
Middle Name:
Last Name:LIBRA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N BAYSHORE DR APT 1603
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-3225
Mailing Address - Country:US
Mailing Address - Phone:954-873-3550
Mailing Address - Fax:
Practice Address - Street 1:7210 S RED RD STE 218
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5321
Practice Address - Country:US
Practice Address - Phone:954-873-3550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-08
Last Update Date:2014-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS1018103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool