Provider Demographics
NPI:1760230007
Name:DELVALLE, JOYANA AMANDA
Entity type:Individual
Prefix:
First Name:JOYANA
Middle Name:AMANDA
Last Name:DELVALLE
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 1:2960 GRAND CONCOURSE APT L2
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-1910
Mailing Address - Country:US
Mailing Address - Phone:347-577-5844
Mailing Address - Fax:
Practice Address - Street 1:2960 GRAND CONCOURSE APT L2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-1910
Practice Address - Country:US
Practice Address - Phone:347-577-5844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-10
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker