Provider Demographics
NPI:1013594720
Name:QUESADA, DAIMI (BCBA)
Entity type:Individual
Prefix:
First Name:DAIMI
Middle Name:
Last Name:QUESADA
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 LAKE CHARLOTTE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-2286
Mailing Address - Country:US
Mailing Address - Phone:786-757-9224
Mailing Address - Fax:
Practice Address - Street 1:111 LAKE CHARLOTTE CREEK DR
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-2286
Practice Address - Country:US
Practice Address - Phone:786-757-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-27
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-24-75566103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst