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Individual

ANJERICA DONNELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2400 SE FEDERAL HWY STE 220, STUART, FL 34994-4556
(772) 678-6704
(772) 221-9969
Mailing address
2400 SE FEDERAL HWY STE 220, STUART, FL 34994-4556
(772) 678-6704
(772) 221-9969

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-62959
FL
106S00000X
Behavior Technician
RBT-18-71693

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022577600
FL
Enumeration date
06/07/2019
Last updated
01/03/2023
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