Provider Demographics
NPI:1861007189
Name:CEDENO, MARIA TERESA
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:TERESA
Last Name:CEDENO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:TERESA
Other - Last Name:CEDENO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA
Mailing Address - Street 1:10410 S OCEAN DR APT 304
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-2506
Mailing Address - Country:US
Mailing Address - Phone:786-865-9218
Mailing Address - Fax:
Practice Address - Street 1:1490 S MILITARY TRL STE 7
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-9141
Practice Address - Country:US
Practice Address - Phone:561-323-2552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-130056106S00000X
FL1-23-68431103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBCBA-123-68431OtherBEHAVIOR ANALYST
FLRBT-20-130056OtherLICENSE CERTIFICATION