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General NPI Number Information
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NPI Number | 1861994816
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Entity Type | Individual
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Provider Name | MS. MAELYS C MOREJON
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Gender | Female
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Dates
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Enumeration Date | 03/06/2018
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 7875 NW 12TH ST STE 109
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City | DORAL
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State | FL
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Zip | 33126-1815
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Country | US
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Telephone | 786-269-3502
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Fax | 305-468-6154
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Provider Business Mailing Address
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Address Line | 155 W 31ST ST
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City | HIALEAH
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State | FL
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Zip | 33012-5418
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Country | US
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Telephone | 786-975-6234
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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 | 0-21-12899
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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 | 1-23-65947
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License Number State | FL
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