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General NPI Number Information
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NPI Number | 1770219230
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Entity Type | Individual
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Provider Name | JUDITH LUACES
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Gender | Female
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Dates
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Enumeration Date | 07/27/2022
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Last Update Date | 03/09/2024
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Provider Practice Location Address
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Address Line | 10425 SW 112TH AVE APT 112
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City | MIAMI
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State | FL
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Zip | 33176-8204
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Country | US
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Telephone | 786-445-3213
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Fax |
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Provider Business Mailing Address
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Address Line | 10425 SW 112TH AVE APT 112
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City | MIAMI
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State | FL
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Zip | 33176-8204
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Country | US
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Telephone | 786-445-3213
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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-20-133393
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | BCABA-0-24-15084
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License Number State | FL
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