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General NPI Number Information
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NPI Number | 1639522089
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Entity Type | Individual
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Provider Name | ISEL MOREJON COSTE
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Gender | Female
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Dates
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Enumeration Date | 07/21/2016
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Last Update Date | 02/14/2019
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Provider Practice Location Address
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Address Line | 12025 SW 14TH ST APT 203
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City | MIAMI
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State | FL
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Zip | 33184-2485
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Country | US
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Telephone | 786-548-7086
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Fax |
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Provider Business Mailing Address
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Address Line | 12025 SW 14TH ST APT 203
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City | MIAMI
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State | FL
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Zip | 33184-2485
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Country | US
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Telephone | 786-348-5369
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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-15-05595
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | RBT-15-05595
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License Number State | FL
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