Individual
ANGELA MCCLASKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QASP-S
Contact information
Practice address
296 S FERDON BLVD, CRESTVIEW, FL 32536-3702
(850) 333-1279
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-63527
FL
106E00000X
Assistant Behavior Analyst
11553
FL
106S00000X
Behavior Technician
BACB594799
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-23-63527
BCBA
FL
01
—
11553
QASP-S
FL
Enumeration date
08/19/2020
Last updated
01/06/2023
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