Individual
AMANDA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18150 NW 59TH AVE APT 203, HIALEAH, FL 33015-5668
(305) 903-8277
Mailing address
18150 NW 59TH AVE APT 203, HIALEAH, FL 33015-5668
(305) 903-8277
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-203493
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-22-203493
BACB - BEHAVIOR ANALYST CERTIFICATION BOARD
FL
Enumeration date
02/21/2022
Last updated
02/21/2022
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