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General NPI Number Information
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NPI Number | 1790928281
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Entity Type | Individual
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Provider Name | JOHANNA W. GUERRERO PHD
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Gender | Female
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Dates
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Enumeration Date | 04/13/2009
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 5190 NW 167TH ST STE 215
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City | MIAMI LAKES
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State | FL
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Zip | 33014-6338
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Country | US
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Telephone | 305-456-4147
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Fax | 305-381-5292
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Provider Business Mailing Address
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Address Line | 5803 NW 97TH DR
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City | PARKLAND
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State | FL
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Zip | 33076-1850
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Country | US
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Telephone | 817-707-6307
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 33487
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY 8056
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License Number State | FL
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