Individual
MS. IRIS ALTAGRACIA MOLINA MUTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7473 SW 82ND ST APT A312, MIAMI, FL 33143-7353
(786) 867-4376
Mailing address
7815 SW 88TH ST APT E326, MIAMI, FL 33156-7729
(305) 606-6195
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-19-9759
FL
106S00000X
Behavior Technician
RBT-18-60572
FL
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31224695
—
FL
Enumeration date
12/24/2015
Last updated
06/19/2019
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