Provider Demographics
NPI:1346845948
Name:BIVIECA VALLEJO, ROSANNY Y (MA, EDM)
Entity type:Individual
Prefix:
First Name:ROSANNY
Middle Name:Y
Last Name:BIVIECA VALLEJO
Suffix:
Gender:F
Credentials:MA, EDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 W 14TH ST STE 506
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-7403
Mailing Address - Country:US
Mailing Address - Phone:929-777-0173
Mailing Address - Fax:
Practice Address - Street 1:39 W 14TH ST STE 506
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7403
Practice Address - Country:US
Practice Address - Phone:929-777-0173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor