Individual
JUDITH FORTEZA CORDERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8480 SW 150TH AVE APT 104, MIAMI, FL 33193-1454
(786) 499-6915
Mailing address
8480 SW 150TH AVE APT 104, MIAMI, FL 33193-1454
(786) 499-6915
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-20-11636
FL
106S00000X
Behavior Technician
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Other
Enumeration date
01/18/2018
Last updated
12/01/2022
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