Provider Demographics
NPI:1497290340
Name:DR. GUERRERO'S ACTION THERAPY, LLC
Entity Type:Organization
Organization Name:DR. GUERRERO'S ACTION THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:859-489-8155
Mailing Address - Street 1:5111 SE MILES GRANT RD APT 201
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-1827
Mailing Address - Country:US
Mailing Address - Phone:859-489-8155
Mailing Address - Fax:
Practice Address - Street 1:555 S COLORADO AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3025
Practice Address - Country:US
Practice Address - Phone:859-489-8155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 9449103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty