Provider Demographics
NPI:1396506184
Name:CASTILLO COBAS, LIANNE (RBT)
Entity type:Individual
Prefix:
First Name:LIANNE
Middle Name:
Last Name:CASTILLO COBAS
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 1:210 W 68TH ST APT 108
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5382
Mailing Address - Country:US
Mailing Address - Phone:239-307-8106
Mailing Address - Fax:
Practice Address - Street 1:1082 10TH AVE NE
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-3676
Practice Address - Country:US
Practice Address - Phone:239-307-8106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-315058106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician