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NPI 1811414824

NPI 1811414824 : NIAMEY ALFONSO : LEHIGH ACRES, FL

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General NPI Number Information
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    NPI Number           |    1811414824
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    Entity Type          |    Individual 
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    Provider Name        |    NIAMEY ALFONSO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/29/2017
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    Last Update Date     |    03/11/2026
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Provider Practice Location Address
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    Address Line         |    916 ANTHONY ST E 
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    City                 |    LEHIGH ACRES
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    State                |    FL
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    Zip                  |    33974-9745
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    Country              |    US
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    Telephone            |    305-968-0518
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    916 ANTHONY ST E 
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    City                 |    LEHIGH ACRES
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    State                |    FL
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    Zip                  |    33974-9745
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    Country              |    US
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    Telephone            |    305-968-0518
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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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Taxonomy #2
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    Taxonomy Code        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    1-26-88157
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    License Number State |    FL
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