Provider Demographics
NPI:1235589755
Name:MANSO ACOSTA, MIRIAM ESTHER I (RBT)
Entity type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:ESTHER
Last Name:MANSO ACOSTA
Suffix:I
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 1:11455 SW 57TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1009
Mailing Address - Country:US
Mailing Address - Phone:786-768-8020
Mailing Address - Fax:
Practice Address - Street 1:11455 SW 57TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1009
Practice Address - Country:US
Practice Address - Phone:786-768-8020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLBACB319341103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician