Provider Demographics
NPI:1639796444
Name:REYES HERNANDEZ, JEYSI (RBT)
Entity Type:Individual
Prefix:MS
First Name:JEYSI
Middle Name:
Last Name:REYES HERNANDEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2213 OXFORD RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33973-6042
Mailing Address - Country:US
Mailing Address - Phone:239-628-2150
Mailing Address - Fax:
Practice Address - Street 1:2213 OXFORD RIDGE CIR
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33973-6042
Practice Address - Country:US
Practice Address - Phone:239-628-2150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-26
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-121301106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician