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Provider Information for 1609210764


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KRISTHEL VALLEJO


Sex: Female

NPI: 1609210764
Last Updated: 2025-04-03
Certification Date: 2025-04-03

Details

NameValue
NPI1609210764
Enumeration Date2013-04-19
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 12601 SW 13TH ST
APT. 211G
PEMBROKE PINES, FL 33027-2160
United States

Phone: 305-915-6464 | Fax:
 
Primary Practice Address 7031 TAFT ST
HOLLYWOOD, FL 33024-3864
United States

Phone: 954-276-0831 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthFLMH17258