Genesis Del Valle Velasquez Miranda
Behavior Technician in West Melbourne, FL. Individual provider (NPI-1).
NPI number1104725837
StatusActive
Last updated in NPPESOct 31, 2026
Details
- NPI
- 1104725837
- Entity type
- Individual (NPI-1)
- Name
- Genesis Del Valle Velasquez Miranda
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 31, 2026
- Certification date
- Oct 31, 2026
- Last updated
- Oct 31, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | BACB2798581 | FL | Yes |
Practice location
1912 Dairy RdWest Melbourne, FL 32904-4046
Phone 321-413-3366
Mailing address
1852 Integra Dr Unit 112West Melbourne, FL 32904-2036
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