Individual
ANGELINE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., BCBA
Contact information
Practice address
2710 STATEN AVE, ORLANDO, FL 32804-4211
(407) 398-2414
Mailing address
2710 STATEN AVE, ORLANDO, FL 32804-4211
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104244800
—
FL
Enumeration date
03/19/2019
Last updated
09/27/2024
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