Provider Demographics
NPI:1710704408
Name:RABASSA, CARMEN (RBT)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:RABASSA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MRS
Other - First Name:CARMEN
Other - Middle Name:
Other - Last Name:RABASSA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:6020 SW 8TH ST LOT B242
Mailing Address - Street 2:
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5083
Mailing Address - Country:US
Mailing Address - Phone:786-539-7245
Mailing Address - Fax:
Practice Address - Street 1:6020 SW 8TH ST LOT B242
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5083
Practice Address - Country:US
Practice Address - Phone:786-539-7245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-140621106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician