MEDICARE: MS. STEPHANIE C. ONUIGBO RBT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst
2	106S00000X	Behavior Technician		FL

General Provider Information

NPI Number	:	1205385697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STEPHANIE C. ONUIGBO RBT

Provider Business Mailing Address
First Line	:	16201 NE 13TH AVE
Second Line	:
City	:	N MIAMI BEACH
State	:	FL
Zip	:	33162-4607
Country	:	US
Telephone Number	:	786-955-6224
Fax Number	:

Provider Business Practice Location Address
First Line	:	16201 NE 13TH AVE
Second Line	:
City	:	N MIAMI BEACH
State	:	FL
Zip	:	33162-4607
Country	:	US
Telephone Number	:	786-955-6224
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2016
Last Update Date	:	09/30/2019

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