Provider Demographics
NPI:1598507931
Name:MANE, AMANDA DE LA CARIDAD (RBT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:DE LA CARIDAD
Last Name:MANE
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 1:6519 DOVEWOOD PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-4923
Mailing Address - Country:US
Mailing Address - Phone:305-975-1690
Mailing Address - Fax:
Practice Address - Street 1:5706 N HESPERIDES ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-5418
Practice Address - Country:US
Practice Address - Phone:813-924-4609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-351813106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician