Provider Demographics
NPI:1114702073
Name:ORDONEZ, KATHERINE GISELLE (RBT-23-291247)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:GISELLE
Last Name:ORDONEZ
Suffix:
Gender:F
Credentials:RBT-23-291247
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:ORDONEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT-23-291247
Mailing Address - Street 1:2926 NW 192ND LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-2457
Mailing Address - Country:US
Mailing Address - Phone:305-780-1256
Mailing Address - Fax:
Practice Address - Street 1:2926 NW 192ND LN
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-2457
Practice Address - Country:US
Practice Address - Phone:305-780-1256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23-291247106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician