Provider Demographics
NPI:1992567952
Name:GUEVARA SANCHEZ, GRISEL (RBT)
Entity type:Individual
Prefix:MS
First Name:GRISEL
Middle Name:
Last Name:GUEVARA SANCHEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 NW 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6713
Mailing Address - Country:US
Mailing Address - Phone:954-803-0047
Mailing Address - Fax:
Practice Address - Street 1:1034 NW 82ND AVE
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6713
Practice Address - Country:US
Practice Address - Phone:954-803-0047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty