Provider Demographics
NPI:1346018033
Name:VIERA NODAL, TANIA TAMARA (RBT)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:TAMARA
Last Name:VIERA NODAL
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 1:10145 SW 223RD TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1570
Mailing Address - Country:US
Mailing Address - Phone:786-519-7294
Mailing Address - Fax:
Practice Address - Street 1:10145 SW 223RD TER
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1570
Practice Address - Country:US
Practice Address - Phone:786-519-7294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-311565106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician