Individual
MISS IMRENA DEDIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
5825 54TH AVE N, KENNETH CITY, FL 33709-1901
(727) 280-6643
Mailing address
500 110TH AVE N APT 1010, SAINT PETERSBURG, FL 33716-3155
(904) 338-2368
(305) 846-9711
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-26-87039
FL
106E00000X
Assistant Behavior Analyst
Primary
0-23-14460
FL
Other
Enumeration date
04/07/2015
Last updated
03/03/2026
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