Provider Demographics
NPI:1750027330
Name:ESCAMILLA, PRISCILA STEPHANIE (RBT)
Entity Type:Individual
Prefix:
First Name:PRISCILA
Middle Name:STEPHANIE
Last Name:ESCAMILLA
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 1:480 NW 16TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-3151
Mailing Address - Country:US
Mailing Address - Phone:786-795-1645
Mailing Address - Fax:
Practice Address - Street 1:7875 NW 12TH ST # 1O9
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1836
Practice Address - Country:US
Practice Address - Phone:786-269-3502
Practice Address - Fax:305-468-6154
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-07
Last Update Date:2022-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician