Provider Demographics
NPI:1538701008
Name:GRONING PEREZ, PAULA (RBT)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:GRONING PEREZ
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 1:117 SW 10TH ST APT 304
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-3556
Mailing Address - Country:US
Mailing Address - Phone:786-702-3290
Mailing Address - Fax:
Practice Address - Street 1:117 SW 10TH ST APT 304
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3556
Practice Address - Country:US
Practice Address - Phone:786-702-3290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-19102152106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-19-102152OtherBEHAVIOR ANALYST CERTIFICATION BOARD