Provider Demographics
NPI:1699126201
Name:CARO HACES, MARIELA CARIDAD
Entity type:Individual
Prefix:
First Name:MARIELA
Middle Name:CARIDAD
Last Name:CARO HACES
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 1:14961 SW 82ND LN APT 106
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3120
Mailing Address - Country:US
Mailing Address - Phone:786-805-9745
Mailing Address - Fax:
Practice Address - Street 1:14961 SW 82ND LN APT 106
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-3120
Practice Address - Country:US
Practice Address - Phone:786-805-9745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-24
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health