Provider Demographics
NPI:1528602042
Name:VALDES GARCIA, LORENA
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:VALDES GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15200 S JOG RD STE A-3
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-1247
Mailing Address - Country:US
Mailing Address - Phone:561-336-0358
Mailing Address - Fax:
Practice Address - Street 1:15200 S JOG RD STE A-3
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-1247
Practice Address - Country:US
Practice Address - Phone:561-336-0358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician