Healthcare Provider Details

I. General information

NPI: 1649056631
Provider Name (Legal Business Name): MONICA GABRIELA GRAJEDA RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2023
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6825 SW 45TH LN APT 6
MIAMI FL
33155-6821
US

IV. Provider business mailing address

6825 SW 45TH LN APT 6
MIAMI FL
33155-6821
US

V. Phone/Fax

Practice location:
  • Phone: 786-280-0448
  • Fax:
Mailing address:
  • Phone: 178-628-0044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB942991
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: