Individual
ANDREA BONGGI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10300 SW 72ND ST STE 114, MIAMI, FL 33173-3038
(305) 508-5580
Mailing address
14114 SW 93RD LN, MIAMI, FL 33186-1272
(786) 260-4779
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-55665
FL
106E00000X
Assistant Behavior Analyst
0-19-9456
FL
106S00000X
Behavior Technician
RBT-18-56956
FL
Other
Enumeration date
09/04/2018
Last updated
03/28/2022
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