Individual
LISANDRA TIHANNY FUENTES MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3620 NW 101ST ST, MIAMI, FL 33147-1528
(786) 908-3007
Mailing address
3620 NW 101ST ST, MIAMI, FL 33147-1528
(786) 908-3007
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-23-14721
FL
106S00000X
Behavior Technician
RBT-20-111643
FL
Other
Enumeration date
06/23/2022
Last updated
11/26/2024
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