Provider Demographics
NPI:1821720319
Name:CONTRERAS TREVINO, DEMI VALERIA
Entity Type:Individual
Prefix:MISS
First Name:DEMI
Middle Name:VALERIA
Last Name:CONTRERAS TREVINO
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 1:2424 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-1480
Mailing Address - Country:US
Mailing Address - Phone:956-431-0056
Mailing Address - Fax:832-553-7287
Practice Address - Street 1:2424 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-1480
Practice Address - Country:US
Practice Address - Phone:956-431-0056
Practice Address - Fax:832-553-7287
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician