Provider Demographics
NPI:1487477550
Name:RIVERO OJEDA, RAQUEL (RBT-24-367873)
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:RIVERO OJEDA
Suffix:
Gender:F
Credentials:RBT-24-367873
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 NW 132ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-1148
Mailing Address - Country:US
Mailing Address - Phone:786-616-5264
Mailing Address - Fax:
Practice Address - Street 1:260 NW 132ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33182-1148
Practice Address - Country:US
Practice Address - Phone:786-616-5264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-367873106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician