Provider Demographics
NPI:1780986851
Name:HENRIQUEZ, DEIDANIA VENECIA (BS)
Entity type:Individual
Prefix:
First Name:DEIDANIA
Middle Name:VENECIA
Last Name:HENRIQUEZ
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15485 EAGLE NEST LN STE 150
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2200
Mailing Address - Country:US
Mailing Address - Phone:305-316-1820
Mailing Address - Fax:786-396-5317
Practice Address - Street 1:15485 EAGLE NEST LN STE 150
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2200
Practice Address - Country:US
Practice Address - Phone:786-534-3457
Practice Address - Fax:305-406-9478
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker