Provider Demographics
NPI:1114693694
Name:NOGUERA, VANINA ESTHER (RBT)
Entity Type:Individual
Prefix:MRS
First Name:VANINA
Middle Name:ESTHER
Last Name:NOGUERA
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 1:3940 NW 79TH AVE APT 603
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6594
Mailing Address - Country:US
Mailing Address - Phone:786-222-3786
Mailing Address - Fax:
Practice Address - Street 1:3940 NW 79TH AVE APT 603
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6594
Practice Address - Country:US
Practice Address - Phone:786-222-3786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-135877106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
SS03OtherABILITY TO HELP THERAPY GROUP LLC