Individual
SUCELY DIAZ FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18127 NW 89TH PL, HIALEAH, FL 33018-6535
(786) 372-3665
Mailing address
18127 NW 89TH PL, HIALEAH, FL 33018-6535
(786) 372-3665
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
BCABA-020-11106
FL
Other
Enumeration date
11/20/2020
Last updated
03/04/2024
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