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NPI 1114696259

NPI 1114696259 : MONICA M MAURA RBT : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1114696259
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    Entity Type          |    Individual 
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    Provider Name        |    MONICA M MAURA RBT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/11/2021
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    Last Update Date     |    09/11/2021
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Provider Practice Location Address
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    Address Line         |    13834 MADISON ST 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33176-6235
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    Country              |    US
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    Telephone            |    786-499-5382
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    320 SW 118TH AVE 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33184-1713
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    Country              |    US
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    Telephone            |    178-649-9538
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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       |    
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    License Number State |    
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