Provider Demographics
NPI:1427692318
Name:ALTUVE, ERIKA LISSETTE (RBT)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:LISSETTE
Last Name:ALTUVE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MS
Other - First Name:ERIKA
Other - Middle Name:LISSETTE
Other - Last Name:ALTUVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10280 NW 63RD TER APT 209
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3082
Mailing Address - Country:US
Mailing Address - Phone:786-448-2566
Mailing Address - Fax:
Practice Address - Street 1:10280 NW 63RD TER APT 209
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-3082
Practice Address - Country:US
Practice Address - Phone:786-448-2566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty