Healthcare Provider Details

I. General information

NPI: 1912354655
Provider Name (Legal Business Name): YANEY GUERRA GARCIA BCBA 1-19-35153
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2016
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 174TH ST APT 619
SUNNY ISL BCH FL
33160-3316
US

IV. Provider business mailing address

231 174TH ST APT 619
SUNNY ISL BCH FL
33160-3316
US

V. Phone/Fax

Practice location:
  • Phone: 786-468-9977
  • Fax:
Mailing address:
  • Phone: 786-468-9977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-35153
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: