Provider Demographics
NPI:1790383735
Name:SUAREZ MACHIN, DENICE (RBT)
Entity Type:Individual
Prefix:
First Name:DENICE
Middle Name:
Last Name:SUAREZ MACHIN
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 1:2136 BONNIE DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-7206
Mailing Address - Country:US
Mailing Address - Phone:561-229-8508
Mailing Address - Fax:
Practice Address - Street 1:1521 FOREST HILL BLVD STE 3
Practice Address - Street 2:
Practice Address - City:LAKE CLARKE SHORES
Practice Address - State:FL
Practice Address - Zip Code:33406-6031
Practice Address - Country:US
Practice Address - Phone:561-444-2814
Practice Address - Fax:561-444-2458
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19-86712106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician