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General NPI Number Information
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NPI Number | 1093112195
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Entity Type | Individual
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Provider Name | VICNAN ALEISHA TORRES M.S.
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Gender | Female
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Dates
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Enumeration Date | 12/04/2014
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Last Update Date | 07/26/2016
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Provider Practice Location Address
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Address Line | 9270 SW 150 AVE SUITE 302
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City | MIAMI
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State | FL
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Zip | 33196-1585
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Country | US
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Telephone | 786-553-7233
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Fax |
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Provider Business Mailing Address
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Address Line | 6827 SW 128TH CT
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City | MIAMI
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State | FL
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Zip | 33183-2413
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Country | US
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Telephone | 786-553-7233
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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