Individual
AMANDA ROQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5549 NW 194TH LN, MIAMI GARDENS, FL 33055-1601
(786) 343-2589
Mailing address
5549 NW 194TH LN, MIAMI GARDENS, FL 33055-1601
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/08/2021
Last updated
10/08/2021
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