Provider Demographics
NPI:1700579570
Name:GRANDA, ARIANA (RBT-23-274234)
Entity Type:Individual
Prefix:
First Name:ARIANA
Middle Name:
Last Name:GRANDA
Suffix:
Gender:F
Credentials:RBT-23-274234
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14041 SW 74TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-3005
Mailing Address - Country:US
Mailing Address - Phone:786-800-0016
Mailing Address - Fax:
Practice Address - Street 1:14041 SW 74TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-3005
Practice Address - Country:US
Practice Address - Phone:786-800-0016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT23274234106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician