Individual
AUDREY MADELYN MASELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2222 COLONIAL RD STE 100, FORT PIERCE, FL 34950-5309
(772) 489-4726
Mailing address
7814 NW 90TH CT, OKEECHOBEE, FL 34972-7334
(561) 629-4141
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/12/2020
Last updated
02/21/2023
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