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General NPI Number Information
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NPI Number | 1154683159
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Entity Type | Individual
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Provider Name | SUWENDA LOUIS
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Gender | Female
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Dates
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Enumeration Date | 06/14/2012
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Last Update Date | 06/17/2020
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Provider Practice Location Address
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Address Line | 1239 E NEWPORT CENTER DR STE 101
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-7711
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Country | US
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Telephone | 754-444-3707
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Fax |
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Provider Business Mailing Address
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Address Line | 541 SW 63RD AVE
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City | MARGATE
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State | FL
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Zip | 33068-1730
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Country | US
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Telephone | 754-214-9842
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Fax | 954-577-7780
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-18-30663
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License Number State | FL
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