Provider Demographics
NPI:1669820288
Name:GARCIA, YAMILET (RBT 1612074)
Entity Type:Individual
Prefix:
First Name:YAMILET
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RBT 1612074
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19801 SW 110TH CT APT 622
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-8449
Mailing Address - Country:US
Mailing Address - Phone:786-227-0012
Mailing Address - Fax:
Practice Address - Street 1:25050 SW 122ND PL
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8127
Practice Address - Country:US
Practice Address - Phone:786-227-0012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT 1612074103K00000X
FLRBT162074106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT 1612074OtherBACB