Healthcare Provider Details

I. General information

NPI: 1093410706
Provider Name (Legal Business Name): JEANNINEDA SAINT HUBERT BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7778 SW JACK JAMES DR
STUART FL
34997-7249
US

IV. Provider business mailing address

619 NW 46TH AVE
DELRAY BEACH FL
33445-2115
US

V. Phone/Fax

Practice location:
  • Phone: 561-377-0009
  • Fax:
Mailing address:
  • Phone: 321-593-9032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2829437
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: