Provider Demographics
NPI:1376439497
Name:QUICENO, STEFANY
Entity type:Individual
Prefix:
First Name:STEFANY
Middle Name:
Last Name:QUICENO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 BRANDYWINE RD APT 800N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-2051
Mailing Address - Country:US
Mailing Address - Phone:561-764-7202
Mailing Address - Fax:
Practice Address - Street 1:1441 BRANDYWINE RD APT 800N
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-2051
Practice Address - Country:US
Practice Address - Phone:561-764-7202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst