Provider Demographics
NPI:1316438492
Name:POLICARPE, VILAINE
Entity type:Individual
Prefix:
First Name:VILAINE
Middle Name:
Last Name:POLICARPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VILAINE
Other - Middle Name:
Other - Last Name:ALEXIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAIDEN
Mailing Address - Street 1:6807 PORTER RD APT 2
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-5522
Mailing Address - Country:US
Mailing Address - Phone:954-678-8186
Mailing Address - Fax:
Practice Address - Street 1:6807 PORTER RD APT 2
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-5522
Practice Address - Country:US
Practice Address - Phone:954-678-8186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician