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NPI 1457035263

NPI 1457035263 : ROSELY HERR CID : DORAL, FL

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General NPI Number Information
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    NPI Number           |    1457035263
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    Entity Type          |    Individual 
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    Provider Name        |    ROSELY HERR CID
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/12/2023
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    Last Update Date     |    06/12/2023
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Provider Practice Location Address
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    Address Line         |    2898 NW 79TH AVE 
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    City                 |    DORAL
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    State                |    FL
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    Zip                  |    33122-1033
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    Country              |    US
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    Telephone            |    305-597-3861
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    14050 SW 55TH ST 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33175-5933
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    Country              |    US
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    Telephone            |    786-872-2141
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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       |    RBT-20-149638
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    License Number State |    FL
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