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NPI Code Detail

MEDICARE: SANDRA LORELLE GUERRA

MEDICARE: SANDRA LORELLE GUERRA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2103K00000XBehavior AnalystTX

General Provider Information

NPI Number : 1134685001
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA LORELLE GUERRA
Provider Business Mailing Address
First Line : 500 FAIRWAY DR STE 102
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-1817
Country : US
Telephone Number : 888-880-9270
Fax Number :
Provider Business Practice Location Address
First Line : 121 INTERPARK BLVD STE 104
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78216-1844
Country : US
Telephone Number : 888-754-0398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2019
Last Update Date : 05/08/2023

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Directions to “ SANDRA LORELLE GUERRA ” Practice Location

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