Provider Demographics
NPI:1043975980
Name:MORALES VALDES, YAISEL (RBT)
Entity type:Individual
Prefix:
First Name:YAISEL
Middle Name:
Last Name:MORALES VALDES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 BARBER AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-5707
Mailing Address - Country:US
Mailing Address - Phone:561-574-4153
Mailing Address - Fax:
Practice Address - Street 1:7711 N MILITARY TRL STE 1008
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-6506
Practice Address - Country:US
Practice Address - Phone:561-480-1075
Practice Address - Fax:561-584-5836
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-05
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-185152106S00000X, 106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL112477500Medicaid
RBT-21-185152OtherBACB