Provider Demographics
NPI:1649095209
Name:TRETO, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:TRETO
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 1:17927 NW 66TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4406
Mailing Address - Country:US
Mailing Address - Phone:305-495-2549
Mailing Address - Fax:
Practice Address - Street 1:10300 SW 72ND ST STE 407
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3013
Practice Address - Country:US
Practice Address - Phone:786-536-7213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-24-77277103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst