Most Relevant Information
Provider Data
| NPI Number: | 1003381096 |
| Provider Name: | CARMEN LYDIA DEL VALLE-IZURIETA LMHC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | MH16334 |
Most Important Dates
| Enumeration Date: | 10/05/2018 |
| Last Updated: | 10/24/2018 |
Provider Practice Location
2950 HALCYON LN STE 701
JACKSONVILLE
FL
322236692
Practice Location Phone/Fax
| Phone: | 9049233031 |
| Fax: | 9045928681 |
Provider Mailing Location
9838 OLD BAYMEADOWS RD # 182
JACKSONVILLE
FL
322568101
Provider Mailing Phone/Fax
| Phone: | 9049233031 |
| Fax: | 9045928681 |