Individual
AIDA MARIA BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18220 NW 59TH AVE APT 104, HIALEAH, FL 33015-5683
(786) 346-9998
Mailing address
18220 NW 59TH AVE APT 104, HIALEAH, FL 33015-5683
(786) 346-9998
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT1865567
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022970600
—
FL
Enumeration date
09/09/2019
Last updated
03/15/2022
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