| Provider / Organization | NPI | Date Certified |
|---|---|---|
| IMANDRA OLMO FUENTES | 1770227399 | 2022-11-19 |
Imandra Olmo Fuentes is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1770227399. Registration indicates Imandra Olmo Fuentes is a provider of services with a specialization in Behavioral Health & Social Service Providers, Behavior Technician (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, )
| Entity Type | Individual |
| Provider Name | Imandra Olmo Fuentes RBT |
| Practice Office Address | 3229 SW 90TH AVE MIAMI, FL US |
| Practice Office Telephone | 7864269711 |
| Mailing Address | 3229 SW 90TH AVE MIAMI, FL 331654252 US |
| Business Telephone | 7864269711 |
| Code | Practice | License No State |
|---|---|---|
| 106S00000X PRIMARY | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician |