Provider Demographics
NPI:1326882507
Name:GAETA, VALERIE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:GAETA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 W VOORHIS AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-5432
Mailing Address - Country:US
Mailing Address - Phone:386-795-5695
Mailing Address - Fax:
Practice Address - Street 1:247 W VOORHIS AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-5432
Practice Address - Country:US
Practice Address - Phone:386-795-5695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-354065106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician