Provider Demographics
NPI:1568907970
Name:SEGUINOT, DAMARIS
Entity Type:Individual
Prefix:
First Name:DAMARIS
Middle Name:
Last Name:SEGUINOT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAMARIS
Other - Middle Name:
Other - Last Name:SEGUINOT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:1110 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-1132
Mailing Address - Country:US
Mailing Address - Phone:786-501-0032
Mailing Address - Fax:
Practice Address - Street 1:1110 W 26TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-1132
Practice Address - Country:US
Practice Address - Phone:786-501-0032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician