Provider Demographics
NPI:1215706825
Name:ORBEGOSO VILLAGRA, CECILIA (RBT)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:ORBEGOSO VILLAGRA
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 1:3331 W 89TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-2003
Mailing Address - Country:US
Mailing Address - Phone:305-427-3268
Mailing Address - Fax:
Practice Address - Street 1:3625 NW 82ND AVE STE 101
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6633
Practice Address - Country:US
Practice Address - Phone:786-583-8663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician