Provider Demographics
NPI:1245760628
Name:HECHAVARRIA, NIDIA
Entity Type:Individual
Prefix:
First Name:NIDIA
Middle Name:
Last Name:HECHAVARRIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 W FLAGLER ST APT 114
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1259
Mailing Address - Country:US
Mailing Address - Phone:305-213-2933
Mailing Address - Fax:
Practice Address - Street 1:3100 W FLAGLER ST APT 114
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1259
Practice Address - Country:US
Practice Address - Phone:305-213-2933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty