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General NPI Number Information
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NPI Number | 1275078727
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Entity Type | Organization
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Legal Business Name | YES I CAN SI SE PUEDE LLC
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Dates
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Enumeration Date | 12/19/2016
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Last Update Date | 12/19/2016
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Provider Practice Location Address
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Address Line | 5662 OAK HILL MANOR DR
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City | ORLANDO
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State | FL
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Zip | 32839-2502
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Country | US
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Telephone | 321-663-4629
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Fax |
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Provider Business Mailing Address
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Address Line | 5662 OAK HILL MANOR DR
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City | ORLANDO
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State | FL
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Zip | 32839-2502
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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 | MGMR CLINICAL DIRECTOR
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Name | MRS. GLADYS NARANJO
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Credential | BCBA
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Telephone | 321-663-4629
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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 | 11417442
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License Number State | FL
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