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General NPI Number Information
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NPI Number | 1639598550
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Entity Type | Individual
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Provider Name | BRENDALIS RIOS
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Gender | Female
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Dates
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Enumeration Date | 04/08/2014
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 1030 MAPLE VIEW WAY
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City | ORLANDO
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State | FL
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Zip | 32828-6930
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Country | US
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Telephone | 787-431-9520
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 34703
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City | SEATTLE
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State | WA
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Zip | 98124-1703
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Country | US
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Telephone | 206-764-3335
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Fax | 206-764-0489
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CG60433373
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149022529
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 099145
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 60764675
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License Number State | WA
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