Individual
AMANDA WORSHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7075 N HIGHWAY 1, COCOA, FL 32927-5216
(321) 888-3020
Mailing address
1855 W HIBISCUS BLVD, MELBOURNE, FL 32901-2622
(321) 345-4232
(321) 765-6434
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000
RBT
FL
Enumeration date
04/19/2017
Last updated
11/03/2020
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