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General NPI Number Information
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NPI Number | 1992329452
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Entity Type | Individual
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Provider Name | ASIA L NELSON RBT
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Gender | Female
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Dates
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Enumeration Date | 06/01/2020
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 11055 SW 186TH ST STE 306
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City | CUTLER BAY
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State | FL
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Zip | 33157-6843
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Country | US
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Telephone | 786-224-6884
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Fax | 786-688-2483
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Provider Business Mailing Address
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Address Line | 500 FAIRWAY DR STE 102
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-1817
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Country | US
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Telephone | 877-418-2978
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Fax | 866-500-2186
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ISW19126
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 19-99111
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License Number State | GA
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