Individual
E'SYL RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
125 E NASA BLVD, MELBOURNE, FL 32901-1900
(321) 372-6813
(321) 765-6434
Mailing address
125 E NASA BLVD, MELBOURNE, FL 32901-1900
(321) 372-6813
(321) 765-6434
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-20-10916
FL
106S00000X
Behavior Technician
RBT-17-35692
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02138900
—
FL
Enumeration date
06/14/2017
Last updated
02/28/2020
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