Provider Demographics
NPI:1659975829
Name:SANCHEZ, YIRELIS (RBT)
Entity Type:Individual
Prefix:
First Name:YIRELIS
Middle Name:
Last Name:SANCHEZ
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 1:624 SW 132ND TER
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-3242
Mailing Address - Country:US
Mailing Address - Phone:786-458-4858
Mailing Address - Fax:
Practice Address - Street 1:624 SW 132ND TER
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33325-3242
Practice Address - Country:US
Practice Address - Phone:786-458-4858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT20142634106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician