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General NPI Number Information
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NPI Number | 1649160086
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Entity Type | Individual
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Provider Name | GEYSY HERRERA SANTIAGO BACB 1049856
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Gender | Female
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 9975 S US HIGHWAY 1 APT 309
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34952-5670
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Country | US
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Telephone | 786-708-0974
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 N MILITARY TRL STE 304
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City | BOCA RATON
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State | FL
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Zip | 33431-6324
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Country | US
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Telephone | 772-362-9878
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | FL
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