Provider Demographics
NPI:1730823873
Name:DURA MORENO, MARIA AMPARO (MS,BCBA)
Entity type:Individual
Prefix:
First Name:MARIA AMPARO
Middle Name:
Last Name:DURA MORENO
Suffix:
Gender:F
Credentials:MS,BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 222531
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33422-2531
Mailing Address - Country:US
Mailing Address - Phone:305-333-5453
Mailing Address - Fax:
Practice Address - Street 1:188 KENT K
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-1722
Practice Address - Country:US
Practice Address - Phone:305-333-5453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst