Individual
GLORY MATY ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17954 SW 33RD CT, MIRAMAR, FL 33029-1636
(305) 726-3750
Mailing address
17954 SW 33RD CT, MIRAMAR, FL 33029-1636
(305) 726-3750
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
BACB-19-188940
FL
235Z00000X
Speech-Language Pathologist
Primary
SA22621
FL
Other
Enumeration date
09/23/2019
Last updated
02/06/2026
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