Provider Demographics
NPI:1184266025
Name:ROBLES, YAKELIN (RBT)
Entity type:Individual
Prefix:
First Name:YAKELIN
Middle Name:
Last Name:ROBLES
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 1:6857 W 36TH AVE UNIT 204
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-2983
Mailing Address - Country:US
Mailing Address - Phone:786-508-3245
Mailing Address - Fax:
Practice Address - Street 1:6857 W 36TH AVE UNIT 204
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-2983
Practice Address - Country:US
Practice Address - Phone:786-508-3245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-11
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19-99701106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104315200Medicaid