Most Relevant Information
Provider Data
| NPI Number: | 1003564659 |
| Provider Name: | LIUBY SOUBAL NOLASCO |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | 20-117796 |
Most Important Dates
| Enumeration Date: | 03/14/2022 |
| Last Updated: | 03/14/2022 |
Provider Practice Location
7930 SW 158TH CT
MIAMI
FL
331932973
Practice Location Phone/Fax
| Phone: | 7862944864 |
| Fax: |
Provider Mailing Location
7930 SW 158TH CT
MIAMI
FL
331932973
Provider Mailing Phone/Fax
| Phone: | 7862944864 |
| Fax: |