Provider Demographics
NPI:1679014039
Name:MUNIZ GARCIA, GRETTA E (BCBA)
Entity Type:Individual
Prefix:
First Name:GRETTA
Middle Name:E
Last Name:MUNIZ GARCIA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14081 SW 168TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-8003
Mailing Address - Country:US
Mailing Address - Phone:786-257-8485
Mailing Address - Fax:
Practice Address - Street 1:14081 SW 168TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-8003
Practice Address - Country:US
Practice Address - Phone:786-257-8485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-17
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0-19-10027106E00000X
FLRBT-18-73787106S00000X
FL1-21-53532103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician