Provider Demographics
NPI:1528599362
Name:ALVAREZ NODARSE, DIAMELA (BCBA)
Entity Type:Individual
Prefix:
First Name:DIAMELA
Middle Name:
Last Name:ALVAREZ NODARSE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8449 NW 189TH STREET RD
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5391
Mailing Address - Country:US
Mailing Address - Phone:786-474-8844
Mailing Address - Fax:
Practice Address - Street 1:8449 NW 189TH STREET RD
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5391
Practice Address - Country:US
Practice Address - Phone:786-474-8844
Practice Address - Fax:305-742-2190
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-23
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-20-11389106E00000X
FL18-53595106S00000X
FL1-23-70257103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty