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Individual

CHANEL BLANCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
13314 SW 73RD TER, MIAMI, FL 33183-3259
(786) 226-4912
Mailing address
13314 SW 73RD TER, MIAMI, FL 33183-3259
(786) 226-4912

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
19-77400
FL
253Z00000X
In Home Supportive Care Agency
Primary

Other

Enumeration date
02/22/2017
Last updated
04/13/2023
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