Provider Demographics
NPI:1972380186
Name:HENRY, ABBRIELLE MAELYNN (RBT)
Entity Type:Individual
Prefix:MS
First Name:ABBRIELLE
Middle Name:MAELYNN
Last Name:HENRY
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 1:3630 CORAL TREE CIR
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4407
Mailing Address - Country:US
Mailing Address - Phone:302-723-2188
Mailing Address - Fax:
Practice Address - Street 1:22169 CRESSMONT PL
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-4280
Practice Address - Country:US
Practice Address - Phone:561-463-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-278575106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician