Individual
ANA LAURA PONCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8785 SW 165TH AVE STE 103-104, MIAMI, FL 33193-5826
(786) 655-9306
Mailing address
642 NW 5TH AVE APT A206, MIAMI, FL 33136-3294
(305) 479-4924
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
20-139114
FL
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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