Provider Demographics
NPI:1740704121
Name:PIERRE LOUIS, CASSANDRA DECIUS (RBT)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:DECIUS
Last Name:PIERRE LOUIS
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 1:2939 SE BELLA RD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34984-6333
Mailing Address - Country:US
Mailing Address - Phone:561-313-9413
Mailing Address - Fax:
Practice Address - Street 1:123 NW 13TH ST STE 305B
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1645
Practice Address - Country:US
Practice Address - Phone:786-230-6095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-27
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty