Provider Demographics
NPI:1083307532
Name:FEBRES CORDERO, DIANA (BCBA)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:FEBRES CORDERO
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 1:3500 CORAL WAY APT 413
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3064
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:KM 3.5 SAMBORONDON URB PARQUE MAGNO
Practice Address - Street 2:
Practice Address - City:SAMBORONDON
Practice Address - State:GUAYAS
Practice Address - Zip Code:092301
Practice Address - Country:EC
Practice Address - Phone:593-999-4390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-17-27217103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst