Provider Demographics
NPI:1639886542
Name:DIAZ CEPERO, MARIBEL (RBT-22-229668)
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:DIAZ CEPERO
Suffix:
Gender:F
Credentials:RBT-22-229668
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 SAINT LUCIE LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-4719
Mailing Address - Country:US
Mailing Address - Phone:407-669-8197
Mailing Address - Fax:
Practice Address - Street 1:616 SAINT LUCIE LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-4719
Practice Address - Country:US
Practice Address - Phone:407-669-8197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-229668106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician