Provider Demographics
NPI:1235908393
Name:PADRON DE MICHEL, MARIA GRACIELA (RBT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:GRACIELA
Last Name:PADRON DE MICHEL
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 1:3750 INVERRARY DR, 1T, LAUDERHILL, FL, 33319
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-5154
Mailing Address - Country:US
Mailing Address - Phone:954-553-5903
Mailing Address - Fax:
Practice Address - Street 1:3750 INVERRARY DR, 1T, LAUDERHILL, FL, 33319
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-5154
Practice Address - Country:US
Practice Address - Phone:954-553-5903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-29
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-319064106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician