Individual
JESSICA MARIA MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
4800 NW 167TH ST, MIAMI GARDENS, FL 33014-6426
(305) 515-2726
Mailing address
11664 NW 90TH AVE, HIALEAH GARDENS, FL 33018-4156
(305) 842-4984
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
02/28/2020
Last updated
11/16/2023
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