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General NPI Number Information
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NPI Number | 1003452061
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Entity Type | Individual
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Provider Name | YACQUELIN MILAGROS JORRIN
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Gender | Female
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Dates
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Enumeration Date | 11/25/2019
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Last Update Date | 12/17/2019
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Provider Practice Location Address
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Address Line | 20121 SW 118TH AVE
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City | MIAMI
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State | FL
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Zip | 33177-5463
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Country | US
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Telephone | 786-218-9789
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Fax |
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Provider Business Mailing Address
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Address Line | 10689 N KENDALL DR STE 309
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City | MIAMI
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State | FL
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Zip | 33176-1525
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Country | US
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Telephone | 786-536-7470
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-19-101046
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License Number State | FL
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