Individual
DAMARIS LOUISE MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3671 SW 25 ST, MIAMI, FL 33133
(305) 608-4117
Mailing address
3671 SW 25TH ST, MIAMI, FL 33133-2003
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
06/08/2017
Last updated
06/08/2017
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