Provider Demographics
NPI:1053189241
Name:MIRABAL, YARENIA (RBT-23-283785)
Entity type:Individual
Prefix:
First Name:YARENIA
Middle Name:
Last Name:MIRABAL
Suffix:
Gender:F
Credentials:RBT-23-283785
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12460 SW 218TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170-2728
Mailing Address - Country:US
Mailing Address - Phone:305-902-0337
Mailing Address - Fax:
Practice Address - Street 1:12460 SW 218TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-2728
Practice Address - Country:US
Practice Address - Phone:305-902-0337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-283785106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician