Provider Demographics
NPI:1457683948
Name:VELEZ, IVETTE SUSANA (MS)
Entity Type:Individual
Prefix:MISS
First Name:IVETTE
Middle Name:SUSANA
Last Name:VELEZ
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 1:510 THE WOODS # I
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-4705
Mailing Address - Country:US
Mailing Address - Phone:201-838-5233
Mailing Address - Fax:
Practice Address - Street 1:1 COLBY AVE STE 5
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1000
Practice Address - Country:US
Practice Address - Phone:856-541-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health