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General NPI Number Information
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NPI Number | 1174089403
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Entity Type | Individual
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Provider Name | DIANA PUENTES
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Gender | Female
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Dates
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Enumeration Date | 02/12/2019
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 7301A W PALMETTO PARK RD
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City | BOCA RATON
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State | FL
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Zip | 33433-3409
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Country | US
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Telephone | 954-248-1171
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Fax |
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Provider Business Mailing Address
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Address Line | 201 LAKE MONTEREY CIR
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8443
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Country | US
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Telephone | 561-797-6383
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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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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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