Provider Demographics
NPI:1225678659
Name:FERRER, JEZABELL (BCABA)
Entity Type:Individual
Prefix:
First Name:JEZABELL
Middle Name:
Last Name:FERRER
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15679 SW 10TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33194-2420
Mailing Address - Country:US
Mailing Address - Phone:786-444-7996
Mailing Address - Fax:
Practice Address - Street 1:15679 SW 10TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33194-2420
Practice Address - Country:US
Practice Address - Phone:786-444-7996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0-19-10528106E00000X
1-21-48272103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst