Provider Demographics
NPI:1285399865
Name:FEBLES, LIVIA (BCBA)
Entity type:Individual
Prefix:
First Name:LIVIA
Middle Name:
Last Name:FEBLES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MISS
Other - First Name:LIVIA
Other - Middle Name:
Other - Last Name:FEBLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA
Mailing Address - Street 1:2500 SW 107TH AVE STE 37
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2425
Mailing Address - Country:US
Mailing Address - Phone:305-228-3780
Mailing Address - Fax:
Practice Address - Street 1:2500 SW 107TH AVE STE 37
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2425
Practice Address - Country:US
Practice Address - Phone:305-228-3780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12041506103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst