Provider Demographics
NPI:1861710485
Name:GUERCIO, JOHN MICHAEL (PHD BCBA-D CBIST)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:GUERCIO
Suffix:
Gender:M
Credentials:PHD BCBA-D CBIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 HARTCOURT AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62052-2053
Mailing Address - Country:US
Mailing Address - Phone:618-946-6188
Mailing Address - Fax:
Practice Address - Street 1:214 HARTCOURT AVE
Practice Address - Street 2:
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052-2053
Practice Address - Country:US
Practice Address - Phone:618-946-6188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst