Provider Demographics
NPI:1073881892
Name:DELVA, LANDY CLAIRE (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:LANDY
Middle Name:CLAIRE
Last Name:DELVA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 ELDRON BLVD NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-3088
Mailing Address - Country:US
Mailing Address - Phone:321-351-4469
Mailing Address - Fax:
Practice Address - Street 1:11440 OKEECHOBEE BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411
Practice Address - Country:US
Practice Address - Phone:561-316-7517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2946106H00000X
FLIMT1653106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist