Most Relevant Information
Provider Data
| NPI Number: | 1003650102 |
| Provider Name: | CHANEL GONZALEZ LOPEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-24-350160 |
Most Important Dates
| Enumeration Date: | 06/24/2024 |
| Last Updated: | 06/24/2024 |
Provider Practice Location
19870 W DIXIE HWY APT 2208
MIAMI
FL
331802267
Practice Location Phone/Fax
| Phone: | 7862132726 |
| Fax: |
Provider Mailing Location
19870 W DIXIE HWY APT 2208
MIAMI
FL
331802267
Provider Mailing Phone/Fax
| Phone: | 7862132726 |
| Fax: |