Provider Demographics
NPI:1639946221
Name:NOVOA, DANIELLA MARIA (RBT)
Entity Type:Individual
Prefix:
First Name:DANIELLA
Middle Name:MARIA
Last Name:NOVOA
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 1:2951 PARK POND WAY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7661
Mailing Address - Country:US
Mailing Address - Phone:321-355-3904
Mailing Address - Fax:407-201-4782
Practice Address - Street 1:2951 PARK POND WAY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7661
Practice Address - Country:US
Practice Address - Phone:321-355-3904
Practice Address - Fax:407-201-4782
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty