Provider Demographics
NPI:1215779582
Name:AMAYA, YAZMIN (RBT-24-352035)
Entity type:Individual
Prefix:
First Name:YAZMIN
Middle Name:
Last Name:AMAYA
Suffix:
Gender:F
Credentials:RBT-24-352035
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14403 SW 142ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5624
Mailing Address - Country:US
Mailing Address - Phone:786-444-4260
Mailing Address - Fax:
Practice Address - Street 1:14403 SW 142ND CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5624
Practice Address - Country:US
Practice Address - Phone:786-444-4260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-08
Last Update Date:2024-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-352035106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician