Individual
ALICE TOUKOLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14645 NW 77TH AVE STE 105, MIAMI LAKES, FL 33014-2569
(754) 812-8700
Mailing address
795 SW 110TH AVE # 1615, MIAMI, FL 33174-1349
(301) 765-4948
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-202530
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113406600
—
FL
Enumeration date
03/15/2022
Last updated
08/20/2023
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