Individual
ANDREA RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
148 WILSHIRE BLVD, CASSELBERRY, FL 32707-5372
(321) 972-4039
Mailing address
148 WILSHIRE BLVD, CASSELBERRY, FL 32707-5372
(866) 411-6619
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-27484
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-17-27484
BACB
—
Enumeration date
07/13/2016
Last updated
12/28/2018
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