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Vivian M Roque-balboa
Student in an Organized Health Care Education/Training Program in Bronx, New York
NPI 1518626530

Vivian M Roque-balboa is a Student in an Organized Health Care Education/Training Program based in Bronx, NY. Vivian M Roque-balboa practices in Bronx, NY. The NPI Number for Vivian M Roque-balboa is 1518626530 and holds a License No. (New York).

The current practice location address for Vivian M Roque-balboa is 579 Courtlandt Ave, Bronx, NY and can be reached out via phone at 718-485-2100.

Location: 579 Courtlandt Ave, Bronx, NY, 10463-3285
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518626530
Provider Name
Vivian M Roque-balboa
Credential
Provider Entity Type
Individual
Gender
Female
Address
579 Courtlandt Ave, Bronx, NY, 10463-3285
Phone Number
718-485-2100
Fax Number
Provider Enumeration Date
12/17/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
579 Courtlandt Ave
City
Bronx
State
New York
Zip
10451-5013
Phone Number
718-485-2100
Fax Number
person
Provider Business Mailing Address Details
Address
579 Courtlandt Ave
City
Bronx
State
New York
Zip
10451-5013
Phone Number
718-485-2100
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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