Provider Demographics
NPI:1437823838
Name:MENESES, ANNA LIA (RBT)
Entity Type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:LIA
Last Name:MENESES
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 1:2235 EVEREST PKWY
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-3351
Mailing Address - Country:US
Mailing Address - Phone:786-848-9341
Mailing Address - Fax:
Practice Address - Street 1:2235 EVEREST PKWY
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-3351
Practice Address - Country:US
Practice Address - Phone:786-848-9341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-177859106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician