Individual
ANGELICA F WACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1107 MABBETTE ST, KISSIMMEE, FL 34741-5161
(407) 201-8079
Mailing address
1500 S DOUGLAS RD, CORAL GABLES, FL 33134-4108
(844) 244-1818
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
2355S0801X
Speech-Language Assistant
Primary
SI7124
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7124
—
FL
Enumeration date
05/14/2024
Last updated
08/26/2024
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