Healthcare Provider Details

I. General information

NPI: 1578026761
Provider Name (Legal Business Name): HELEN BARBARA GRAU DIAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2019
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9525 SW 24TH ST APT D211
MIAMI FL
33165-8063
US

IV. Provider business mailing address

9525 SW 24TH ST APT D211
MIAMI FL
33165-8063
US

V. Phone/Fax

Practice location:
  • Phone: 786-450-0997
  • Fax:
Mailing address:
  • Phone: 786-450-0997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-26-2830845
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: