Provider Demographics
NPI:1376209759
Name:SALAZAR, YANESCAT C (RBT)
Entity Type:Individual
Prefix:
First Name:YANESCAT
Middle Name:C
Last Name:SALAZAR
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 1:8435 SW 156TH CT APT 1013
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1238
Mailing Address - Country:US
Mailing Address - Phone:305-495-4296
Mailing Address - Fax:
Practice Address - Street 1:8435 SW 156TH CT APT 1013
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-1238
Practice Address - Country:US
Practice Address - Phone:305-495-4296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20123868106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician