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General NPI Number Information
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NPI Number | 1740704121
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Entity Type | Individual
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Provider Name | CASSANDRA DECIUS PIERRE LOUIS RBT
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Gender | Female
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Dates
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Enumeration Date | 07/27/2017
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 123 NW 13TH ST STE 305B
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City | BOCA RATON
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State | FL
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Zip | 33432-1645
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Country | US
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Telephone | 786-230-6095
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Fax |
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Provider Business Mailing Address
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Address Line | 2939 SE BELLA RD
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City | PORT ST LUCIE
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State | FL
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Zip | 34984-6333
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Country | US
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Telephone | 561-313-9413
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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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