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Individual

ALEXIS RENEE KISSANE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, BCBA

Contact information

Practice address
6900 TAVISTOCK LAKES BLVD STE 400, ORLANDO, FL 32827-7593
(800) 875-1871
(800) 875-1871
Mailing address
2268 LITCHFIELD LOOP, DELAND, FL 32720-3387
(260) 431-1525

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-26-89515
FL
106E00000X
Assistant Behavior Analyst
0-25-16255
FL
106S00000X
Behavior Technician
RBT-20-148899

Other

Enumeration date
10/13/2023
Last updated
04/24/2026
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