Individual
MS. ALLIE MARIE ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., BCBA
Contact information
Practice address
171 CANAL BLVD, PONTE VEDRA BEACH, FL 32082-3607
(904) 647-1849
Mailing address
171 CANAL BLVD, PONTE VEDRA BEACH, FL 32082-3607
(904) 647-1849
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-73229
FL
103K00000X
Behavior Analyst
2080
NC
106S00000X
Behavior Technician
RBT-21-167700
FL
Other
Enumeration date
05/13/2021
Last updated
09/25/2024
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