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General NPI Number Information
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NPI Number | 1205608015
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Entity Type | Individual
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Provider Name | MARA DENISSE RIVERA TORRES
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Gender | Female
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Dates
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Enumeration Date | 10/25/2023
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 8180 NW 36TH ST STE 317
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City | DORAL
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State | FL
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Zip | 33166-6674
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Country | US
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Telephone | 786-652-1513
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Fax |
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Provider Business Mailing Address
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Address Line | 16277 SW 96TH TER
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City | MIAMI
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State | FL
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Zip | 33196-5938
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Country | US
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Telephone |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | RBT-23-305525
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License Number State | FL
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