Provider Demographics
NPI:1093298366
Name:SANCHEZ, DEAN P II (PCA, RBT)
Entity type:Individual
Prefix:MR
First Name:DEAN
Middle Name:P
Last Name:SANCHEZ
Suffix:II
Gender:M
Credentials:PCA, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 RENAISSANCE COMMONS BLVD APT 309
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8263
Mailing Address - Country:US
Mailing Address - Phone:303-550-2376
Mailing Address - Fax:
Practice Address - Street 1:2355 STATE ST STE 101
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4541
Practice Address - Country:US
Practice Address - Phone:303-550-2376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2024-08-12
Deactivation Date:2019-06-04
Deactivation Code:
Reactivation Date:2019-07-19
Provider Licenses
StateLicense IDTaxonomies
106S00000X
ORR9717101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician