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1942076575
MARY LAURA LEIVA DOMINGUEZ
FORT MYERS, FL
NPI
1942076575
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
(Licence: FL RBT-23-311319)
Enumeration Date
2023-11-27
Last Update Date
2023-12-07
Business Address
MARY LAURA LEIVA DOMINGUEZ
8359 BEACON BLVD STE 416
FORT MYERS, FL 33907-3065
Phone number: 800-920-1927
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Mailing Address
MARY LAURA LEIVA DOMINGUEZ
17465 BUTLER RD
FORT MYERS, FL 33967-2955
Phone number: 239-600-1037
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