Provider Demographics
NPI:1992691547
Name:PADILLA FERNANDEZ, VALERIA MARIE (RBT)
Entity type:Individual
Prefix:MISS
First Name:VALERIA
Middle Name:MARIE
Last Name:PADILLA FERNANDEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E AVON RD
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:19015-3307
Mailing Address - Country:US
Mailing Address - Phone:787-299-2391
Mailing Address - Fax:
Practice Address - Street 1:215 E AVON RD
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:PA
Practice Address - Zip Code:19015-3307
Practice Address - Country:US
Practice Address - Phone:787-299-2391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician