Individual
YAMILET MESA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5112 NW 79TH AVE APT 208, DORAL, FL 33166-4734
(786) 683-8481
Mailing address
5112 NW 79TH AVE APT 208, DORAL, FL 33166-4734
(786) 683-8481
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
FL
106S00000X
Behavior Technician
—
—
247200000X
Other Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017673100
—
FL
Enumeration date
05/26/2016
Last updated
12/04/2019
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