Provider Demographics
NPI:1770217655
Name:VALECILLOS, GIOVANNA F
Entity Type:Individual
Prefix:
First Name:GIOVANNA
Middle Name:F
Last Name:VALECILLOS
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 1:16623 NW 70TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-7103
Mailing Address - Country:US
Mailing Address - Phone:754-265-8137
Mailing Address - Fax:
Practice Address - Street 1:16623 NW 70TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-7103
Practice Address - Country:US
Practice Address - Phone:754-265-8137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-15
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician