Provider Demographics
NPI:1679920516
Name:BARAHONA, GLADYS
Entity type:Individual
Prefix:
First Name:GLADYS
Middle Name:
Last Name:BARAHONA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 DELAWARE PKWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1116
Mailing Address - Country:US
Mailing Address - Phone:305-790-5257
Mailing Address - Fax:
Practice Address - Street 1:1930 DELAWARE PKWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1116
Practice Address - Country:US
Practice Address - Phone:305-790-5257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst