Dianndra Yadyra Ibarra, RBT-21-173019

Individual provider Active NPI Behavior Technician · Goulds, FL

NPI 1023768587 · NPPES record last updated Mar 28, 2022

Key facts

NPI
1023768587
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-21-173019 (FL)
Practice address
11276 SW 232ND St
Goulds, FL 33170-7505
Phone
(305) 912-8399
NPI assigned
Mar 28, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-21-173019FLMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-21-173019 FL Yes

Addresses

Primary practice location

11276 SW 232ND St
Goulds, FL 33170-7505

Mailing address

1211 NE 12TH Ave Apt 104
Homestead, FL 33030-5046
Phone (786) 407-8111

Other providers in Goulds, FL

All providers in Goulds, FL · Behavior Technician in Florida

Sources for this page

Verify at the official NPI Registry.