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Organization

THE ENGAGE ABA RESOURCE AND LEARNING CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAZZMYN IGLESIA MS (BCABA)
(407) 780-0177
Entity
Organization

Contact information

Practice address
13506 SUMMERPORT VILLAGE PKWY # 207, WINDERMERE, FL 34786-7366
(407) 780-0177
Mailing address
13506 SUMMERPORT VILLAGE PKWY # 207, WINDERMERE, FL 34786-7366
(407) 780-0177

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0-15-6527
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
601834
FL
Enumeration date
09/23/2015
Last updated
09/23/2015
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