Individual
MILDRED DIAZ MASIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1106 NW 18TH PL, CAPE CORAL, FL 33993-5902
(239) 308-7537
Mailing address
1106 NW 18TH PL, CAPE CORAL, FL 33993-5902
(239) 308-7537
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-21-11943
—
Other
Enumeration date
08/02/2018
Last updated
08/27/2021
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