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Individual

VANESSA FAJARDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9000 SW 137TH AVE, MIAMI, FL 33186-1411
(786) 615-9400
Mailing address
13961 SW 122ND AVE APT 304, MIAMI, FL 33186-6260

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103573200
FL
Enumeration date
11/02/2019
Last updated
07/25/2025
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