Provider Demographics
NPI:1629681820
Name:JAIME MARIN, JENNIFER SUSANA (RBT)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:SUSANA
Last Name:JAIME MARIN
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 1:7348 SW 82ND ST APT C218
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7430
Mailing Address - Country:US
Mailing Address - Phone:305-282-0013
Mailing Address - Fax:
Practice Address - Street 1:10250 SW 56 ST
Practice Address - Street 2:D201
Practice Address - City:MIAMI
Practice Address - State:FLORIDA
Practice Address - Zip Code:33165
Practice Address - Country:US
Practice Address - Phone:888-527-8037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-131816106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician