Individual
AMANDA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12708 HOLYOKE AVE, TAMPA, FL 33624-4230
(813) 300-8167
Mailing address
12708 HOLYOKE AVE, TAMPA, FL 33624-4230
(813) 300-8167
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BCBA-1-22-59919
FL
106S00000X
Behavior Technician
RBT-20-133288
FL
Other
Enumeration date
09/16/2020
Last updated
09/13/2024
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