Provider Demographics
NPI:1497566301
Name:VALERIO, JIVELYS
Entity type:Individual
Prefix:
First Name:JIVELYS
Middle Name:
Last Name:VALERIO
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 1:29 SASSAFRAS ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02907-2025
Mailing Address - Country:US
Mailing Address - Phone:401-259-9231
Mailing Address - Fax:
Practice Address - Street 1:29 SASSAFRAS ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-2025
Practice Address - Country:US
Practice Address - Phone:401-259-9231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst