Provider Demographics
NPI:1275117798
Name:ROSALES, DAILYS (RBT)
Entity Type:Individual
Prefix:
First Name:DAILYS
Middle Name:
Last Name:ROSALES
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 1:9141 SW 72ND AVE APT W4
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-1636
Mailing Address - Country:US
Mailing Address - Phone:786-306-7146
Mailing Address - Fax:
Practice Address - Street 1:19001 SW 106TH AVE STE C103
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7669
Practice Address - Country:US
Practice Address - Phone:786-523-2352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-98667106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty