Provider Demographics
NPI:1770241952
Name:GARCIA PEREZ, WENDY (RBT)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:GARCIA PEREZ
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 1:9348 NW 120TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GDNS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4217
Mailing Address - Country:US
Mailing Address - Phone:786-614-6922
Mailing Address - Fax:
Practice Address - Street 1:2873 EXECUTIVE PARK DR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3603
Practice Address - Country:US
Practice Address - Phone:754-812-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-04
Last Update Date:2021-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician