Provider Demographics
NPI:1730912965
Name:MORALES, YADIRA (RBT)
Entity type:Individual
Prefix:
First Name:YADIRA
Middle Name:
Last Name:MORALES
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 1:15874 SW 60TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3688
Mailing Address - Country:US
Mailing Address - Phone:786-296-8418
Mailing Address - Fax:
Practice Address - Street 1:2555 NW 102ND AVE STE 215
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2131
Practice Address - Country:US
Practice Address - Phone:305-226-0551
Practice Address - Fax:305-226-0552
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-368939106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician