Most Relevant Information
Provider Data
| NPI Number: | 1003678202 |
| Provider Name: | ALICIA DIAZ DOMINGUEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-21-158784 |
Most Important Dates
| Enumeration Date: | 01/24/2024 |
| Last Updated: | 01/24/2024 |
Provider Practice Location
3066 S JOG RD
GREENACRES
FL
334672053
Practice Location Phone/Fax
| Phone: | 5617884086 |
| Fax: |
Provider Mailing Location
4090 BELLE RD
LAKE WORTH
FL
334612705
Provider Mailing Phone/Fax
| Phone: | 9563092440 |
| Fax: |