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Organization
ABA ANYWHERE
Active
Organization
ABA ANYWHERE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELIN CLARKE BCBA (CLINICAL DIRECTOR)
(407) 906-1477
Entity
Organization
Contact information
Practice address
4837 TELLSON PL, ORLANDO, FL 32812-8673
(407) 906-1477
Mailing address
4837 TELLSON PL, ORLANDO, FL 32812-8673
(407) 906-1477
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
NULL
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
NULL
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
NULL
106S00000X
Behavior Technician
—
—
251E00000X
Home Health Agency
Primary
—
NULL
Other
Enumeration date
06/28/2022
Last updated
09/06/2023
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