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Individual

GLENDA C JUAREZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
18209 SW 114TH CT, MIAMI, FL 33157-4986
(305) 299-4360
Mailing address
18209 SW 114TH CT, MIAMI, FL 33157-4986
(305) 299-4360

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
252Y00000X
Early Intervention Provider Agency
Primary
590839562
FL

Other

Enumeration date
10/07/2014
Last updated
05/08/2018
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