Individual
AILEN QUESADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4920 SW 94TH CT, MIAMI, FL 33165-6424
(786) 773-6413
Mailing address
4920 SW 94TH CT, MIAMI, FL 33165-6424
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-116464
FL
Other
Enumeration date
05/01/2020
Last updated
05/01/2020
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