Provider Demographics
NPI:1720554066
Name:CORZO, NASHLEY CLARA (RBT)
Entity Type:Individual
Prefix:
First Name:NASHLEY
Middle Name:CLARA
Last Name:CORZO
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 1:18818 NW 83RD PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5345
Mailing Address - Country:US
Mailing Address - Phone:786-303-4038
Mailing Address - Fax:
Practice Address - Street 1:18818 NW 83RD PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5345
Practice Address - Country:US
Practice Address - Phone:786-303-4038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-14
Last Update Date:2018-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst