Provider Demographics
NPI:1952838070
Name:CASALI, YOHANA
Entity Type:Individual
Prefix:
First Name:YOHANA
Middle Name:
Last Name:CASALI
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 1:14727 SW 9TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33194-2903
Mailing Address - Country:US
Mailing Address - Phone:786-873-4167
Mailing Address - Fax:
Practice Address - Street 1:4662 NW 107TH AVE APT 1903
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4261
Practice Address - Country:US
Practice Address - Phone:786-703-6218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-19
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician