Provider Demographics
NPI:1649018193
Name:CORREA, VALERIA ISABEL (BSP)
Entity type:Individual
Prefix:
First Name:VALERIA
Middle Name:ISABEL
Last Name:CORREA
Suffix:
Gender:F
Credentials:BSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PINE ISLAND CIRCLE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34743
Mailing Address - Country:US
Mailing Address - Phone:407-844-9133
Mailing Address - Fax:
Practice Address - Street 1:609 W VINE ST STE C3
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4182
Practice Address - Country:US
Practice Address - Phone:407-844-9133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral