Individual
MISS GISEL FUENTES MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 SE S FEDERAL HIGHWAY SUITE 220, SUITE 102, STUART, FL 34994-4556
(772) 678-6704
(772) 888-1885
Mailing address
2400 SE S FEDERAL HIGHWAY SUITE 220, SUITE 102, STUART, FL 34994-4556
(772) 678-6704
(772) 888-1885
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-20-11523
FL
106S00000X
Behavior Technician
RBT-19-85377
FL
222Q00000X
Developmental Therapist
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Other
Enumeration date
01/10/2014
Last updated
11/18/2020
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