Provider Demographics
NPI:1275287104
Name:DIAZ PEREZ, HELEN (RBT)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:DIAZ PEREZ
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 1:14750 SW 26TH ST STE 208
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5936
Mailing Address - Country:US
Mailing Address - Phone:786-615-4750
Mailing Address - Fax:786-279-0915
Practice Address - Street 1:3645 SW 90TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-4356
Practice Address - Country:US
Practice Address - Phone:786-597-9114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-144455106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician