Lissette M Soria Vidal

NPI #1013420470 in Hollywood, Florida

Provider Information

NPI Number: 1013420470
Entity Type: Individual
Name: Lissette M Soria Vidal
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Nov 8, 2017
Last Updated: Nov 8, 2017

Practice Location

Address: 1632 MCKINLEY ST
City: Hollywood
State: Florida
ZIP Code: 33020-3238
Phone: (585) 750-0568

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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