Provider Demographics
NPI:1609521343
Name:AMOR, MARIANA (RBT)
Entity Type:Individual
Prefix:
First Name:MARIANA
Middle Name:
Last Name:AMOR
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1401 SW 1ST ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2261
Mailing Address - Country:US
Mailing Address - Phone:305-400-8998
Mailing Address - Fax:786-360-1296
Practice Address - Street 1:1401 SW 1ST ST STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2261
Practice Address - Country:US
Practice Address - Phone:305-400-8998
Practice Address - Fax:786-360-1296
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-22-203968106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician