Provider Demographics
NPI:1790507705
Name:RIVAL CASTILLO, YAIMI C (RBT-24-387908)
Entity type:Individual
Prefix:
First Name:YAIMI
Middle Name:C
Last Name:RIVAL CASTILLO
Suffix:
Gender:F
Credentials:RBT-24-387908
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 NE 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-1331
Mailing Address - Country:US
Mailing Address - Phone:561-396-8460
Mailing Address - Fax:
Practice Address - Street 1:1309 NE 7TH AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-1331
Practice Address - Country:US
Practice Address - Phone:561-396-8460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-387908106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician