Provider Demographics
NPI:1073289989
Name:PICHARDO, SANDY (RBT)
Entity Type:Individual
Prefix:MR
First Name:SANDY
Middle Name:
Last Name:PICHARDO
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 1:3087 SE 6TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7173
Mailing Address - Country:US
Mailing Address - Phone:786-872-1527
Mailing Address - Fax:
Practice Address - Street 1:3087 SE 6TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7173
Practice Address - Country:US
Practice Address - Phone:786-872-1527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician