Provider Demographics
NPI:1639945199
Name:LOPEZ MOLINA, ARIANET (RBT-23-300968)
Entity Type:Individual
Prefix:
First Name:ARIANET
Middle Name:
Last Name:LOPEZ MOLINA
Suffix:
Gender:F
Credentials:RBT-23-300968
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 COLONIAL BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1025
Mailing Address - Country:US
Mailing Address - Phone:321-208-0047
Mailing Address - Fax:
Practice Address - Street 1:1500 COLONIAL BLVD STE 102
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1025
Practice Address - Country:US
Practice Address - Phone:321-208-0047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-300968106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician