Provider Demographics
NPI:1255781506
Name:CLAVIJO HERNANDEZ, ANA MARGARITA (BCBA)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:MARGARITA
Last Name:CLAVIJO HERNANDEZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 NW 36TH ST APT 606
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-5015
Mailing Address - Country:US
Mailing Address - Phone:305-490-9168
Mailing Address - Fax:
Practice Address - Street 1:3530 NW 36TH ST APT 606
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-5015
Practice Address - Country:US
Practice Address - Phone:305-490-9168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-19-10337106E00000X
FL1-21-55760103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst