Provider Demographics
NPI:1407324338
Name:GUITART, WENDY (RBT-18-67754)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:GUITART
Suffix:
Gender:F
Credentials:RBT-18-67754
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 W 31ST ST APT 1
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4848
Mailing Address - Country:US
Mailing Address - Phone:786-709-5353
Mailing Address - Fax:
Practice Address - Street 1:1200 W 31ST ST APT 1
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4848
Practice Address - Country:US
Practice Address - Phone:786-709-5353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-18-67754106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician