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General NPI Number Information
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NPI Number | 1326687880
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Entity Type | Individual
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Provider Name | KEIDYS ECHEVARRIA
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Gender | Female
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Dates
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Enumeration Date | 01/02/2020
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Last Update Date | 07/12/2021
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Provider Practice Location Address
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Address Line | 4576 BELVEDERE RD APT 2
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City | HAVERHILL
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State | FL
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Zip | 33415-1381
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Country | US
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Telephone | 305-440-9050
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Fax |
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Provider Business Mailing Address
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Address Line | 4576 BELVEDERE RD APT 2
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City | HAVERHILL
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State | FL
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Zip | 33415-1381
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Country | US
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Telephone | 305-440-9050
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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 | BCBA-1-21-50936
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License Number State | FL
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