Provider Demographics
NPI:1134715436
Name:ECHEVARRIA, LEYDIS
Entity type:Individual
Prefix:MS
First Name:LEYDIS
Middle Name:
Last Name:ECHEVARRIA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LEYDIS
Other - Middle Name:
Other - Last Name:ECHEVARRIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8821 NW 108TH LN
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4524
Mailing Address - Country:US
Mailing Address - Phone:786-266-2103
Mailing Address - Fax:
Practice Address - Street 1:8821 NW 108TH LN
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-4524
Practice Address - Country:US
Practice Address - Phone:786-266-2103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician