Provider Demographics
NPI:1356017370
Name:PAULINO NOA, YUDILENNIS (RBT)
Entity Type:Individual
Prefix:
First Name:YUDILENNIS
Middle Name:
Last Name:PAULINO NOA
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 1:3905 NE 20TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5119
Mailing Address - Country:US
Mailing Address - Phone:786-792-4770
Mailing Address - Fax:
Practice Address - Street 1:3905 NE 20TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5119
Practice Address - Country:US
Practice Address - Phone:786-792-4770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-19
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician