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Individual
FREDY MANUEL FONSECA AVILA SR.
Active
Individual
FREDY MANUEL FONSECA AVILA SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RBT
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-118657
FL
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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