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General NPI Number Information
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NPI Number | 1609223577
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Entity Type | Individual
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Provider Name | YANISLEY MORALES VALDIVIA
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Gender | Female
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Dates
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Enumeration Date | 05/19/2016
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Last Update Date | 04/04/2022
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Provider Practice Location Address
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Address Line | 1660 SOUTHERN BLVD STE C
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-3219
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Country | US
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Telephone | 786-461-9978
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Fax |
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Provider Business Mailing Address
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Address Line | 19954 NW 60TH CT
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City | HIALEAH
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State | FL
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Zip | 33015-4876
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Country | US
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Telephone | 786-461-9978
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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 | BCBA1-20-40603
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License Number State | FL
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