Provider Demographics
NPI:1780343715
Name:ACOSTA PIMENTEL, MARLENI
Entity type:Individual
Prefix:
First Name:MARLENI
Middle Name:
Last Name:ACOSTA PIMENTEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 W 47TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3948
Mailing Address - Country:US
Mailing Address - Phone:786-970-2784
Mailing Address - Fax:
Practice Address - Street 1:1376 WILLOW RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5066
Practice Address - Country:US
Practice Address - Phone:786-970-2784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-17
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty