Provider Demographics
NPI:1013570902
Name:FALCON SOSA, YANARYS (RBT)
Entity Type:Individual
Prefix:
First Name:YANARYS
Middle Name:
Last Name:FALCON SOSA
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 1:19124 NW 48TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-2018
Mailing Address - Country:US
Mailing Address - Phone:786-444-3480
Mailing Address - Fax:
Practice Address - Street 1:19124 NW 48TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-2018
Practice Address - Country:US
Practice Address - Phone:786-444-3480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19-83721106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician