Provider Demographics
NPI:1891541751
Name:ADAY DIAZ, MAYRELIS (RBT-24-343906)
Entity type:Individual
Prefix:
First Name:MAYRELIS
Middle Name:
Last Name:ADAY DIAZ
Suffix:
Gender:F
Credentials:RBT-24-343906
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 SW 7TH CT
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-2421
Mailing Address - Country:US
Mailing Address - Phone:786-250-9805
Mailing Address - Fax:
Practice Address - Street 1:924 SW 7TH CT
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-2421
Practice Address - Country:US
Practice Address - Phone:786-250-9805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-343906106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician