Odette Campos Diaz

Individual provider Active NPI Behavior Technician · Labelle, FL

NPI 1649013111 · NPPES record last updated Jun 13, 2024

Key facts

NPI
1649013111
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-24-345935 (FL)
Practice address
700 S Main St
Labelle, FL 33935-4440
Phone
(239) 544-8602
NPI assigned
Jun 13, 2024
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-24-345935FLMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24-345935 FL Yes

Addresses

Primary practice location

700 S Main St
Labelle, FL 33935-4440

Mailing address

409 Hollywood St
Lehigh Acres, FL 33936-1679

Other providers in Labelle, FL

All providers in Labelle, FL · Behavior Technician in Florida

Sources for this page

Verify at the official NPI Registry.