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Individual

MIRNA CAROLINA PACHECO CACERES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5911 NW 173RD DR UNIT 11, HIALEAH, FL 33015-5122
(786) 803-0112
Mailing address
50 W 31ST ST APT 101, HIALEAH, FL 33012-5463
(786) 803-0112

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-24-15262
FL
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022835800
FL
Enumeration date
11/01/2017
Last updated
07/15/2024
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