Provider Demographics
NPI:1356214274
Name:HERNANDEZ DEL VALLE, KATHERINE ENID
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ENID
Last Name:HERNANDEZ DEL VALLE
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 1:8428 TROUTMAN ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-6209
Mailing Address - Country:US
Mailing Address - Phone:321-440-0552
Mailing Address - Fax:
Practice Address - Street 1:8428 TROUTMAN ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-6209
Practice Address - Country:US
Practice Address - Phone:321-440-0552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-356846106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician