Provider Demographics
NPI:1942856430
Name:FERNANDEZ MARRERO, CINDY MILAGROS (BCBA)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:MILAGROS
Last Name:FERNANDEZ MARRERO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8025 SW 107TH AVE APT 313
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4836
Mailing Address - Country:US
Mailing Address - Phone:786-372-5305
Mailing Address - Fax:305-675-8040
Practice Address - Street 1:8025 SW 107TH AVE APT 313
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4836
Practice Address - Country:US
Practice Address - Phone:786-372-5305
Practice Address - Fax:305-675-8040
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty