Provider Demographics
NPI:1518610328
Name:FERRAIUOLO, IRENE M (RBT)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:M
Last Name:FERRAIUOLO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:IRENE
Other - Middle Name:M
Other - Last Name:FERRAIUOLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:1525 CROWBERRY LN
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-6545
Mailing Address - Country:US
Mailing Address - Phone:954-326-8566
Mailing Address - Fax:
Practice Address - Street 1:900 27TH AVE
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4011
Practice Address - Country:US
Practice Address - Phone:772-569-5699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-168788106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician