Individual
ANA IRIS GONZALEZ URRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1600 SW SYLVESTER LN, PORT ST LUCIE, FL 34984-3605
(772) 333-4411
(772) 353-5951
Mailing address
4201 SW HAGAPLAN ST, PORT ST LUCIE, FL 34953-6583
(561) 480-5351
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-147681
FL
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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