Individual
ALYSSA BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1750 TREE BLVD STE 6, ST AUGUSTINE, FL 32084-5719
(904) 206-7024
Mailing address
936 SCHEIDEL WAY, ST AUGUSTINE, FL 32084-6617
(412) 652-3022
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-34807
—
106S00000X
Behavior Technician
RBT-16-25232
PA
Other
Enumeration date
02/21/2017
Last updated
01/30/2023
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