Provider Demographics
NPI:1003345604
Name:GUTIERREZ DE LEON, YANAIKY CARIDAD (BCBA)
Entity Type:Individual
Prefix:
First Name:YANAIKY
Middle Name:CARIDAD
Last Name:GUTIERREZ DE LEON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7083 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1673
Mailing Address - Country:US
Mailing Address - Phone:786-458-1350
Mailing Address - Fax:
Practice Address - Street 1:7083 SW 21ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1673
Practice Address - Country:US
Practice Address - Phone:786-458-1350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-07
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-20-44026103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst