Provider Demographics
NPI:1639888902
Name:ARCIA GUERRERO, GISELLE (RBT)
Entity Type:Individual
Prefix:
First Name:GISELLE
Middle Name:
Last Name:ARCIA GUERRERO
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 1:668 GLENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-2206
Mailing Address - Country:US
Mailing Address - Phone:407-202-1020
Mailing Address - Fax:
Practice Address - Street 1:668 GLENVIEW DR
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-2206
Practice Address - Country:US
Practice Address - Phone:407-202-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22-240945106S00000X
FLRBT-22-240945106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician