Individual
MARISA MAXIMOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
8673 15TH WAY N, SAINT PETERSBURG, FL 33702-2815
(727) 423-0060
(727) 369-8803
Mailing address
5339 NEIL DR APT 6, SAINT PETERSBURG, FL 33714-2406
(909) 977-0121
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-22-204756
FL
222Q00000X
Developmental Therapist
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
222Q00000
DEVELOPMENTAL THERAPIST
FL
Enumeration date
02/28/2022
Last updated
03/13/2025
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