Provider Demographics
NPI:1457998197
Name:FERGUSON, YEUMICA (RBT)
Entity Type:Individual
Prefix:
First Name:YEUMICA
Middle Name:
Last Name:FERGUSON
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:PO BOX 344152
Mailing Address - Street 2:
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034-9582
Mailing Address - Country:US
Mailing Address - Phone:305-812-9327
Mailing Address - Fax:305-812-9327
Practice Address - Street 1:655 SE 28TH LN
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5758
Practice Address - Country:US
Practice Address - Phone:305-812-9327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-02
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist