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Individual

KRISTEN VANDERLELY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., ITDS

Contact information

Practice address
1609 SW 13TH CT, FORT LAUDERDALE, FL 33312-4147
(954) 815-4738
Mailing address
1609 SW 13TH CT, FORT LAUDERDALE, FL 33312-4147
(954) 815-4738

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
222Q00000X
Developmental Therapist
Primary

Other

Enumeration date
09/18/2015
Last updated
02/23/2018
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