Individual
MRS. ANIXA N/A ROQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CABA
Contact information
Practice address
622 SW 99TH PL, MIAMI, FL 33174-1887
(305) 485-8486
(305) 485-8486
Mailing address
622 SW 99TH PL, MIAMI, FL 33174-1887
(305) 485-8486
(305) 485-8486
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0-04-1362
FL
Other
Enumeration date
09/22/2010
Last updated
09/22/2010
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