Provider Demographics
NPI:1609428820
Name:MIRABAL, ANABEL (RBT)
Entity Type:Individual
Prefix:
First Name:ANABEL
Middle Name:
Last Name:MIRABAL
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 1:10689 N KENDALL DR STE 309
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1525
Mailing Address - Country:US
Mailing Address - Phone:305-536-7470
Mailing Address - Fax:
Practice Address - Street 1:1090 W 40TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4188
Practice Address - Country:US
Practice Address - Phone:786-781-3107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-78464106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT-19-78464OtherBEHAVIOR ANALUST CERTIFICATION BOARD