Provider Demographics
NPI:1457709537
Name:VALLADARES, MAYULYS CONCEPCION
Entity Type:Individual
Prefix:MS
First Name:MAYULYS
Middle Name:CONCEPCION
Last Name:VALLADARES
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 1:1001 E CAREY AVE APT 806
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-1808
Mailing Address - Country:US
Mailing Address - Phone:702-980-2186
Mailing Address - Fax:
Practice Address - Street 1:1001 E CAREY AVE APT 806
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-1808
Practice Address - Country:US
Practice Address - Phone:702-980-2186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-30
Last Update Date:2016-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst