Provider Demographics
NPI:1922672609
Name:HENRI, CLEOPATRA (RBT)
Entity Type:Individual
Prefix:
First Name:CLEOPATRA
Middle Name:
Last Name:HENRI
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 1:6902 W HILLSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-4946
Mailing Address - Country:US
Mailing Address - Phone:916-753-5133
Mailing Address - Fax:
Practice Address - Street 1:11602 N 51ST ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-2132
Practice Address - Country:US
Practice Address - Phone:813-541-7791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-153747106S00000X
CARBT-21-153747106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician