Provider Demographics
NPI:1427560234
Name:VALLEDOR, MARIA TERESITA
Entity type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:TERESITA
Last Name:VALLEDOR
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MARIA
Other - Middle Name:TERESITA
Other - Last Name:VALLEDOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12485 SW 137TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4216
Mailing Address - Country:US
Mailing Address - Phone:786-449-7490
Mailing Address - Fax:305-846-9711
Practice Address - Street 1:12485 SW 137TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4216
Practice Address - Country:US
Practice Address - Phone:786-449-7490
Practice Address - Fax:305-846-9711
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician