Individual
BRIDGET ANITA SHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA-D
Contact information
Practice address
2050 CLASSIQUE LN, TAVARES, FL 32778-5787
(352) 508-5243
Mailing address
36227 E ELDORADO LAKE DR, EUSTIS, FL 32736-9474
(941) 357-6840
(352) 602-4145
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-04-1993
FL
Other
Enumeration date
05/17/2017
Last updated
05/17/2017
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