Provider Demographics
NPI:1821752841
Name:CALVO, ANDREA (MS, RBT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:CALVO
Suffix:
Gender:F
Credentials:MS, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 CLEMATIS ST APT 406
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-5395
Mailing Address - Country:US
Mailing Address - Phone:305-733-6156
Mailing Address - Fax:
Practice Address - Street 1:610 CLEMATIS ST APT 406
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-5395
Practice Address - Country:US
Practice Address - Phone:305-733-6156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108687500Medicaid