Individual
DR. DANIELLE ROSE LISO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD., BCBA-D
Contact information
Practice address
6867 SOUTHPOINT DR N, SUITE 101, JACKSONVILLE, FL 32216-8043
(904) 619-6071
Mailing address
4393 PEBBLE BROOK DR, JACKSONVILLE, FL 32224-5661
(386) 214-4868
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-05-2316
FL
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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