Provider Demographics
NPI:1205650348
Name:FARIAS SANCHEZ, DIANA (RBT)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:FARIAS SANCHEZ
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 1:18768 SW 47TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-6219
Mailing Address - Country:US
Mailing Address - Phone:754-837-1954
Mailing Address - Fax:
Practice Address - Street 1:18768 SW 47TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-6219
Practice Address - Country:US
Practice Address - Phone:754-837-1954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-387852106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician