Provider Demographics
NPI:1407598733
Name:SOMOZA-HERRERA, ROSA ANGELICA (RBT)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:ANGELICA
Last Name:SOMOZA-HERRERA
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 1:408 NW 68TH AVE APT 509
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-7520
Mailing Address - Country:US
Mailing Address - Phone:786-510-2333
Mailing Address - Fax:
Practice Address - Street 1:408 NW 68TH AVE APT 509
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-7520
Practice Address - Country:US
Practice Address - Phone:786-510-2333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-207212103K00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst