Provider Demographics
NPI:1326728544
Name:ALLEN HERRERO, SUSANA (RBT-23-285706)
Entity Type:Individual
Prefix:MRS
First Name:SUSANA
Middle Name:
Last Name:ALLEN HERRERO
Suffix:
Gender:F
Credentials:RBT-23-285706
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 MONTEGO DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-3843
Mailing Address - Country:US
Mailing Address - Phone:754-707-3894
Mailing Address - Fax:
Practice Address - Street 1:871 MONTEGO DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-3843
Practice Address - Country:US
Practice Address - Phone:754-707-3894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-285706106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician