Individual
ANA LAURA EUCEDA MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1326 NW 43RD ST, MIAMI, FL 33142-7954
(786) 301-2127
Mailing address
1326 NW 43RD ST, MIAMI, FL 33142-7954
(786) 301-2127
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-348627
FL
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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