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General NPI Number Information
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NPI Number | 1063270924
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Entity Type | Individual
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Provider Name | SANDRA G BAEZ
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Gender | Female
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Dates
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Enumeration Date | 03/06/2024
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 5180 W ATLANTIC AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8103
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Country | US
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Telephone | 561-674-9996
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Fax |
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Provider Business Mailing Address
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Address Line | 729 NW DUPRE ST
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City | PORT ST LUCIE
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State | FL
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Zip | 34983-8314
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Country | US
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Telephone | 561-506-2873
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-23-295939
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License Number State | FL
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