Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-20-10947 | FL |
N | 106S00000X | Behavior Technician |
NPI | 1023588662 |
---|---|
Provider Name | Maribel Rivero Socarras |
First Address | Fort Lauderdale, FL 33334-3527 |
Second Address | Homestead, FL 33035-1173 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2018 |
Last Update Date | 22/04/2021 |