Individual
AMANDA BLAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15080 SW 180TH ST, MIAMI, FL 33187-6273
(863) 553-1707
Mailing address
15080 SW 180TH ST, MIAMI, FL 33187-6273
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-334889
FL
Other
Enumeration date
04/26/2024
Last updated
04/26/2024
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