Provider Demographics
NPI:1679881429
Name:DELVA, SHIRLEY (PHD)
Entity type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:
Last Name:DELVA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 NE 163RD ST
Mailing Address - Street 2:SUITE 300 F
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-4927
Mailing Address - Country:US
Mailing Address - Phone:786-565-7925
Mailing Address - Fax:305-948-9785
Practice Address - Street 1:2020 NE 163RD ST
Practice Address - Street 2:SUITE300 F
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4927
Practice Address - Country:US
Practice Address - Phone:786-565-7925
Practice Address - Fax:305-948-9785
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8268103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist