Provider Demographics
NPI:1629765805
Name:BECERRA, DALYANIS MARIE
Entity Type:Individual
Prefix:
First Name:DALYANIS
Middle Name:MARIE
Last Name:BECERRA
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 1:4225 SW 121ST LN APT 201
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3837
Mailing Address - Country:US
Mailing Address - Phone:786-670-4132
Mailing Address - Fax:
Practice Address - Street 1:4225 SW 121ST LN APT 201
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-3837
Practice Address - Country:US
Practice Address - Phone:786-670-4132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical