Provider Demographics
NPI:1235997685
Name:GALVEZ VIERA, INGRID I (RBT)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:I
Last Name:GALVEZ VIERA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27241 SW 139TH PL
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-5529
Mailing Address - Country:US
Mailing Address - Phone:786-992-6264
Mailing Address - Fax:
Practice Address - Street 1:27241 SW 139TH PL
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-5529
Practice Address - Country:US
Practice Address - Phone:786-992-6264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-331657106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician