Provider Demographics
NPI:1982130027
Name:SAINT PREUX, AGNES
Entity type:Individual
Prefix:
First Name:AGNES
Middle Name:
Last Name:SAINT PREUX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5921 WASHINGTON ST
Mailing Address - Street 2:APT 120
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33023-1971
Mailing Address - Country:US
Mailing Address - Phone:786-304-8483
Mailing Address - Fax:
Practice Address - Street 1:7310 W MCNAB RD
Practice Address - Street 2:204
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-5332
Practice Address - Country:US
Practice Address - Phone:561-316-6132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst