Most Relevant Information
Provider Data
| NPI Number: | 1003517707 |
| Provider Name: | LIEINY LUMEY GONZALEZ MORA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-23-260812 |
Most Important Dates
| Enumeration Date: | 03/10/2023 |
| Last Updated: | 03/21/2023 |
Provider Practice Location
1521 FOREST HILL BLVD STE 3
LAKE CLARKE SHORES
FL
334066031
Practice Location Phone/Fax
| Phone: | 5614442814 |
| Fax: | 5614442458 |
Provider Mailing Location
251 BONNIE BLVD APT 225
PALM SPRINGS
FL
334611316
Provider Mailing Phone/Fax
| Phone: | 5619329264 |
| Fax: |