Provider Demographics
NPI:1952072084
Name:MACHADO, YADIRA (RBT)
Entity Type:Individual
Prefix:
First Name:YADIRA
Middle Name:
Last Name:MACHADO
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 1:10262 NW 131ST ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1208
Mailing Address - Country:US
Mailing Address - Phone:305-608-4759
Mailing Address - Fax:
Practice Address - Street 1:10262 NW 131ST ST
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-1208
Practice Address - Country:US
Practice Address - Phone:305-608-4759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty