Provider Demographics
NPI:1922518695
Name:CORREA, ASTRID MICHELLE
Entity Type:Individual
Prefix:
First Name:ASTRID
Middle Name:MICHELLE
Last Name:CORREA
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 1:838 SALZEDO ST # 33134
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2823
Mailing Address - Country:US
Mailing Address - Phone:872-383-3107
Mailing Address - Fax:
Practice Address - Street 1:838 SALZEDO ST # 33134
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2823
Practice Address - Country:US
Practice Address - Phone:787-238-3310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician