Individual
ALYSSA ROSE DE PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 AMALFI WAY, KISSIMMEE, FL 34758
(407) 995-6106
Mailing address
22 AMALFI WAY, KISSIMMEE, FL 34758-3403
(407) 729-5532
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/31/2021
Last updated
03/31/2021
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