Provider Demographics
NPI:1649097239
Name:HERNANDEZ, VALENTINA JOSEFINA (RBT-24-372823)
Entity type:Individual
Prefix:
First Name:VALENTINA
Middle Name:JOSEFINA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RBT-24-372823
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 JOAN AVE N
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-5947
Mailing Address - Country:US
Mailing Address - Phone:239-333-9465
Mailing Address - Fax:
Practice Address - Street 1:4600 JOAN AVE N
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-5947
Practice Address - Country:US
Practice Address - Phone:239-333-9465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-372823106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician