Individual
ALYSSA NICOLE DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11276 SW 232ND ST, GOULDS, FL 33170-7505
(305) 912-8399
Mailing address
15617 SW 62ND TER, MIAMI, FL 33193-2583
(786) 307-8113
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-265382
FL
Other
Enumeration date
04/12/2023
Last updated
04/12/2023
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