Individual
MERCEDES M FUENTES VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1365 W 28TH ST APT 3NA, HIALEAH, FL 33010-1036
(786) 346-9383
Mailing address
1365 W 28TH ST APT 3, HIALEAH, FL 33010-1036
(786) 346-9383
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-23-14956
FL
106S00000X
Behavior Technician
RBT-19-99125
FL
Other
Enumeration date
09/23/2019
Last updated
01/03/2024
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