Basic Information
Provider Information
NPI: 1003153040
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUERRERO
FirstName: CHERYL
MiddleName: LYNNE
NamePrefix: DR.
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1650 W MAIN ST STE 1
Address2:  
City: LEESBURG
State: FL
PostalCode: 347482842
CountryCode: US
TelephoneNumber: 3526304133
FaxNumber: 3523142909
Practice Location
Address1: 1650 W MAIN ST
Address2: UNIT 1
City: LEESBURG
State: FL
PostalCode: 34748
CountryCode: US
TelephoneNumber: 3027401287
FaxNumber: 3523142909
Other Information
ProviderEnumerationDate: 01/10/2013
LastUpdateDate: 08/02/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X  Y Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


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