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General NPI Number Information
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NPI Number | 1629792072
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Entity Type | Individual
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Provider Name | SEBASTIAN VALLE RBT
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Gender | Male
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Dates
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Enumeration Date | 09/29/2022
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 6807 W COMMERCIAL BLVD
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City | LAUDERHILL
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State | FL
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Zip | 33319-2116
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Country | US
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Telephone | 754-444-4171
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Fax |
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Provider Business Mailing Address
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Address Line | 3110 NE 8TH AVE
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City | POMPANO BEACH
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State | FL
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Zip | 33064-5333
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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 |
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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 |
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License Number State |
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