Provider Demographics
NPI:1477198505
Name:JIMENEZ CLAVIJO, AYLEN (RBT)
Entity Type:Individual
Prefix:
First Name:AYLEN
Middle Name:
Last Name:JIMENEZ CLAVIJO
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 1:3530 NW 36TH ST APT 606
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-5015
Mailing Address - Country:US
Mailing Address - Phone:305-490-9121
Mailing Address - Fax:
Practice Address - Street 1:3530 NW 36TH ST APT 606
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-5015
Practice Address - Country:US
Practice Address - Phone:305-490-9121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-23-14912106E00000X
FLRBT-19101932106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician