Individual
ANA JEIDY DIAZ GOICOLEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3765 W 6TH LN, HIALEAH, FL 33012-4214
(786) 916-4474
Mailing address
3765 W 6TH LN, HIALEAH, FL 33012-4214
(786) 916-4474
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-116087
FL
Other
Enumeration date
05/20/2020
Last updated
05/20/2020
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