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General NPI Number Information
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NPI Number | 1861206526
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Entity Type | Individual
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Provider Name | REIDALY FUENMAYOR CHACIN
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Gender | Female
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 3501 W VINE ST STE 124
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City | KISSIMMEE
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State | FL
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Zip | 34741-4660
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Country | US
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Telephone | 407-483-3074
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Fax |
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Provider Business Mailing Address
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Address Line | 10081 SELTEN WAY APT 218
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City | ORLANDO
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State | FL
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Zip | 32827-8032
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Country | US
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Telephone | 786-609-2921
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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