Individual
ANGELIN CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
4837 TELLSON PL, ORLANDO, FL 32812-8673
(407) 906-1477
(407) 902-0187
Mailing address
4837 TELLSON PL, ORLANDO, FL 32812-8673
(407) 906-1477
(407) 590-2018
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-9630
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21584300
—
FL
Enumeration date
01/16/2015
Last updated
09/06/2023
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