Provider Demographics
NPI:1427708197
Name:MIRANDA MORALES, MADELINE (RBT)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:MIRANDA MORALES
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 1:7101 SW 89TH CT APT 311
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2452
Mailing Address - Country:US
Mailing Address - Phone:305-713-9224
Mailing Address - Fax:
Practice Address - Street 1:7101 SW 89TH CT APT 311
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2452
Practice Address - Country:US
Practice Address - Phone:305-713-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2024-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician