Individual
AMANDA JUNCO NOVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
566 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34984-5108
(772) 201-0173
(772) 209-7631
Mailing address
2895 SW 144TH PL, MIAMI, FL 33175-7444
(305) 609-1401
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-411371
FL
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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