Provider Demographics
NPI:1538606991
Name:VALE VALDIVIA, DAYAMI
Entity type:Individual
Prefix:
First Name:DAYAMI
Middle Name:
Last Name:VALE VALDIVIA
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 1:1605 HAZEL AVE S
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33976-3013
Mailing Address - Country:US
Mailing Address - Phone:239-565-9901
Mailing Address - Fax:
Practice Address - Street 1:1605 HAZEL AVE S
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33976-3013
Practice Address - Country:US
Practice Address - Phone:239-565-9901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst