Provider Demographics
NPI:1962191791
Name:RIQUELME, NORMA DE LA CARIDAD
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:DE LA CARIDAD
Last Name:RIQUELME
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 1:1908 HIGH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-6158
Mailing Address - Country:US
Mailing Address - Phone:565-396-0721
Mailing Address - Fax:
Practice Address - Street 1:1908 HIGH RIDGE RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-6158
Practice Address - Country:US
Practice Address - Phone:565-396-0721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-270331106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician