Provider Demographics
NPI:1811583099
Name:ACOSTA, MAYTE (RBT)
Entity Type:Individual
Prefix:
First Name:MAYTE
Middle Name:
Last Name:ACOSTA
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 1:6955 NW 186TH ST APT F501
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3402
Mailing Address - Country:US
Mailing Address - Phone:786-873-1905
Mailing Address - Fax:
Practice Address - Street 1:6955 NW 186TH ST APT F501
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3402
Practice Address - Country:US
Practice Address - Phone:786-873-1905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-12
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-125634106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician