Provider Demographics
NPI:1538948294
Name:INFANTE FERNANDEZ, MARIA DE LA CARIDAD
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DE LA CARIDAD
Last Name:INFANTE FERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1767 QUIVER POINT AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-3482
Mailing Address - Country:US
Mailing Address - Phone:239-841-8967
Mailing Address - Fax:
Practice Address - Street 1:1767 QUIVER POINT AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-3482
Practice Address - Country:US
Practice Address - Phone:239-841-8967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT-23-275829103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst