MEDICARE: GLENDA MENENCIA DIAZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1205789450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLENDA MENENCIA DIAZ

Provider Business Mailing Address
First Line	:	2028 KENWOOD RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6420
Country	:	US
Telephone Number	:	561-313-3923
Fax Number	:

Provider Business Practice Location Address
First Line	:	2028 KENWOOD RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6420
Country	:	US
Telephone Number	:	561-313-3923
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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Directions to “ GLENDA MENENCIA DIAZ ” Practice Location

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