Provider Demographics
NPI:1336616333
Name:AMAT, MARISET
Entity type:Individual
Prefix:
First Name:MARISET
Middle Name:
Last Name:AMAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5140 PALM HILL DR APT N250
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-5684
Mailing Address - Country:US
Mailing Address - Phone:561-331-7888
Mailing Address - Fax:
Practice Address - Street 1:5140 PALM HILL DR APT N250
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-5684
Practice Address - Country:US
Practice Address - Phone:561-331-7888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-28
Last Update Date:2018-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician