Provider Demographics
NPI:1508566365
Name:UMANZOR, SAVANNAH D (RBT)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:D
Last Name:UMANZOR
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:D
Other - Last Name:UMANZOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:2501 NW 182ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-3640
Mailing Address - Country:US
Mailing Address - Phone:786-782-0154
Mailing Address - Fax:
Practice Address - Street 1:2501 NW 182ND TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-3640
Practice Address - Country:US
Practice Address - Phone:786-782-0154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst