Provider Demographics
NPI:1902254162
Name:GALLEGO, MAYRING CARIDAD (RBT)
Entity Type:Individual
Prefix:
First Name:MAYRING
Middle Name:CARIDAD
Last Name:GALLEGO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 W 69TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5217
Mailing Address - Country:US
Mailing Address - Phone:305-335-9146
Mailing Address - Fax:
Practice Address - Street 1:915 W 69TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5217
Practice Address - Country:US
Practice Address - Phone:305-335-9146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-28
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician