Provider Demographics
NPI:1891568952
Name:DAGOSTINO SANOJA, MARIA F
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:F
Last Name:DAGOSTINO SANOJA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6453 NW 102ND PATH APT 304
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4703
Mailing Address - Country:US
Mailing Address - Phone:954-669-8618
Mailing Address - Fax:
Practice Address - Street 1:6453 NW 102ND PATH APT 304
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4703
Practice Address - Country:US
Practice Address - Phone:954-669-8618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-23-304618106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician