Provider Demographics
NPI:1336688209
Name:MEDINA ARENCIBIA, YENEY (BCBA, IBA, LBA (NC))
Entity type:Individual
Prefix:
First Name:YENEY
Middle Name:
Last Name:MEDINA ARENCIBIA
Suffix:
Gender:
Credentials:BCBA, IBA, LBA (NC)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7420 NW 5TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1611
Mailing Address - Country:US
Mailing Address - Phone:754-715-9772
Mailing Address - Fax:
Practice Address - Street 1:7420 NW 5TH ST STE 110
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1611
Practice Address - Country:US
Practice Address - Phone:754-715-9772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-24-74612103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst