Provider Demographics
NPI:1225899842
Name:PRIVAT, RENANCIA (BEHAVIOR ASSISTANT)
Entity Type:Individual
Prefix:
First Name:RENANCIA
Middle Name:
Last Name:PRIVAT
Suffix:
Gender:F
Credentials:BEHAVIOR ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 SE 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-4524
Mailing Address - Country:US
Mailing Address - Phone:561-887-7515
Mailing Address - Fax:
Practice Address - Street 1:109 SE 3RD AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-4524
Practice Address - Country:US
Practice Address - Phone:561-887-7515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst