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General NPI Number Information
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NPI Number | 1811570435
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Entity Type | Individual
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Provider Name | GUIANEYA GRAU GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 05/02/2021
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Last Update Date | 05/03/2021
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Provider Practice Location Address
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Address Line | 403 SW 103RD AVE APT 304
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-1881
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Country | US
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Telephone | 954-478-4746
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Fax |
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Provider Business Mailing Address
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Address Line | 6617 DAHLIA DR
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City | MIRAMAR
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State | FL
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Zip | 33023-4910
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Country | US
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Telephone | 786-212-7637
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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 | G625280707570
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License Number State |
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