Individual
GUSTAVO ADOLFO VALENCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1116 N 61ST AVE, HOLLYWOOD, FL 33024-6059
(954) 397-1124
Mailing address
1116 N 61ST AVE, HOLLYWOOD, FL 33024-6059
(954) 397-1124
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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