Provider Demographics
NPI:1720806706
Name:CONTRERAS, ALEXANDER (RBT)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:CONTRERAS
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 SW ARC CT
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-6835
Mailing Address - Country:US
Mailing Address - Phone:305-335-1077
Mailing Address - Fax:
Practice Address - Street 1:1115 SW ARC CT
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-6835
Practice Address - Country:US
Practice Address - Phone:305-335-1077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-377330106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician