Individual
ELIZABETH BACCALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13155 SW 134TH ST STE 207, MIAMI, FL 33186-4488
(786) 842-3624
Mailing address
8909 SW 172ND AVE APT 934, MIAMI, FL 33196-3017
(530) 521-7211
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
2355S0801X
Speech-Language Assistant
Primary
SI4852
FL
Other
Enumeration date
10/05/2020
Last updated
07/02/2021
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