Provider Demographics
NPI:1467827675
Name:NICOLE VALDES, PH.D. AND ASSOCIATES, PA
Entity Type:Organization
Organization Name:NICOLE VALDES, PH.D. AND ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SWAGGERTY-VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:954-465-1633
Mailing Address - Street 1:12955 BISCAYNE BLVD
Mailing Address - Street 2:STE. 306
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2037
Mailing Address - Country:US
Mailing Address - Phone:954-465-1633
Mailing Address - Fax:305-397-1581
Practice Address - Street 1:12955 BISCAYNE BLVD
Practice Address - Street 2:STE. 306
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2037
Practice Address - Country:US
Practice Address - Phone:954-465-1633
Practice Address - Fax:305-397-1581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty