Provider Demographics
NPI:1689339483
Name:CHAVARRIA, CRISTELA DE LA PAZ (RBT)
Entity Type:Individual
Prefix:
First Name:CRISTELA
Middle Name:DE LA PAZ
Last Name:CHAVARRIA
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 1:8260 SW 210TH ST APT 120
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-3474
Mailing Address - Country:US
Mailing Address - Phone:786-729-0014
Mailing Address - Fax:
Practice Address - Street 1:8260 SW 210TH ST APT 120
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-3474
Practice Address - Country:US
Practice Address - Phone:786-729-0014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-05
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-190960106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician