Provider Demographics
NPI:1932865276
Name:LOPEZ GONZALEZ, ANABEL DEL CARMEN (RBT)
Entity Type:Individual
Prefix:
First Name:ANABEL
Middle Name:DEL CARMEN
Last Name:LOPEZ GONZALEZ
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 1:14035 SW 91ST TER # TRR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1215
Mailing Address - Country:US
Mailing Address - Phone:954-548-9368
Mailing Address - Fax:
Practice Address - Street 1:14035 SW 91ST TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1215
Practice Address - Country:US
Practice Address - Phone:954-548-9368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT20144356106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician