Individual
AUDREANNA KATHLEEN TIRADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
148 WILSHIRE BLVD, CASSELBERRY, FL 32707
(407) 978-6085
Mailing address
159 MAPLE DR, KISSIMMEE, FL 34759-5580
(407) 491-8567
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-48705
—
106E00000X
Assistant Behavior Analyst
0-19-10066
—
106S00000X
Behavior Technician
RBT-17-44213
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021142900
—
FL
Enumeration date
03/19/2018
Last updated
11/14/2022
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