Provider Demographics
NPI:1184126443
Name:LEVEILLE, ROSE DANIELLE
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:DANIELLE
Last Name:LEVEILLE
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 1:11601 BISCAYNE BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3151
Mailing Address - Country:US
Mailing Address - Phone:305-200-5095
Mailing Address - Fax:
Practice Address - Street 1:11601 BISCAYNE BLVD STE 310
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3151
Practice Address - Country:US
Practice Address - Phone:305-200-5095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst