Provider Demographics
NPI:1942537709
Name:VALENTINE-ROFFLER, KARLA DIANE
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:DIANE
Last Name:VALENTINE-ROFFLER
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 1:11228 CYPRESS RESERVE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-1322
Mailing Address - Country:US
Mailing Address - Phone:813-892-6015
Mailing Address - Fax:
Practice Address - Street 1:11228 CYPRESS RESERVE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-1322
Practice Address - Country:US
Practice Address - Phone:813-892-6015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-14
Last Update Date:2009-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-02-0558103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst