Jonah Alexander Vidaurre
Behavior Technician in Stuart, FL. Individual provider (NPI-1).
NPI number1629856554
StatusActive
Last updated in NPPESJun 14, 2024
Details
- NPI
- 1629856554
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jonah Alexander Vidaurre
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 20, 2023
- Certification date
- Jun 14, 2024
- Last updated
- Jun 14, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | RBT-23-296118 | FL | Yes |
Practice location
850 Nw Federal Hwy Ste 173Stuart, FL 34994-1019
Phone 772-362-9879
Mailing address
1301 Madison Chase Apt 5West Palm Beach, FL 33411-6214
Phone 561-201-2401
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