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1650 W Main St Unit 1 Leesburg FL 34748-2841 | |
| (302) 740-1287 | |
| (352) 314-2909 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1650 W Main St, Leesburg, Florida |
| Authorized Official Name and Position | Cheryl Lynne Guerrero (OWNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 3523143760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1650 W Main St Ste 1 Leesburg FL 34748-2842 Ph: (302) 740-1287 | 1650 W Main St Unit 1 Leesburg FL 34748-2841 Ph: (302) 740-1287 |
| NPI Number | 1225376130 |
|---|---|
| Provider Enumeration Date | 01/28/2013 |
| Last Update Date | 08/17/2021 |
| Certification Date | 10/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225376130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-02-0775 (Florida) | Primary |
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