Provider Demographics
NPI:1093112195
Name:TORRES, VICNAN ALEISHA (MS)
Entity Type:Individual
Prefix:
First Name:VICNAN
Middle Name:ALEISHA
Last Name:TORRES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6827 SW 128TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-2413
Mailing Address - Country:US
Mailing Address - Phone:786-553-7233
Mailing Address - Fax:
Practice Address - Street 1:9270 SW 150 AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1585
Practice Address - Country:US
Practice Address - Phone:786-553-7233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-04
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst