Provider Demographics
NPI:1679846638
Name:DIRENY, RICHELLE ANN
Entity Type:Individual
Prefix:
First Name:RICHELLE ANN
Middle Name:
Last Name:DIRENY
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 1:2163 W 73RD ST UNIT 4
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5551
Mailing Address - Country:US
Mailing Address - Phone:305-825-3872
Mailing Address - Fax:305-825-3873
Practice Address - Street 1:2163 W 73RD ST UNIT 4
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5551
Practice Address - Country:US
Practice Address - Phone:305-825-3872
Practice Address - Fax:305-825-3873
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical