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General NPI Number Information
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NPI Number | 1598341166
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Entity Type | Individual
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Provider Name | PATRICIA BARRERO WONG
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Gender | Female
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Dates
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Enumeration Date | 03/23/2021
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Last Update Date | 03/23/2021
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Provider Practice Location Address
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Address Line | 1881 NW 123RD AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-3825
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Country | US
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Telephone | 954-589-5697
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Fax |
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Provider Business Mailing Address
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Address Line | 157 E 5TH ST UNIT 206
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City | HIALEAH
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State | FL
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Zip | 33010-5071
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Country | US
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Telephone | 786-309-0941
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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-20-125969
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License Number State | FL
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