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General NPI Number Information
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NPI Number | 1336828763
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Entity Type | Organization
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Legal Business Name | VTS THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 07/13/2023
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 8424 SW 200TH TER
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City | CUTLER BAY
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State | FL
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Zip | 33189-2032
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Country | US
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Telephone | 305-215-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 8424 SW 200TH TER
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City | CUTLER BAY
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State | FL
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Zip | 33189-2032
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Country | US
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Telephone | 305-215-7600
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | MRS. VANESSA AZUCENA TERCERO
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Credential | LCSW
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Telephone | 305-215-7600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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