Provider Demographics
NPI:1871149112
Name:MENA, DAYNE (RBT)
Entity type:Individual
Prefix:
First Name:DAYNE
Middle Name:
Last Name:MENA
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 1:161 E 44TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1817
Mailing Address - Country:US
Mailing Address - Phone:786-397-4185
Mailing Address - Fax:305-675-8040
Practice Address - Street 1:161 E 44TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1817
Practice Address - Country:US
Practice Address - Phone:786-397-4185
Practice Address - Fax:305-675-8040
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician