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Individual

CARLOS MANUEL CHICA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6844 INTERNATIONAL CENTER BLVD STE 500, FORT MYERS, FL 33912-7159
(417) 860-7640
Mailing address
124 SW 31ST ST, CAPE CORAL, FL 33914-4555
(305) 917-5901

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
FL
106S00000X
Behavior Technician

Other

Enumeration date
12/23/2017
Last updated
02/01/2021
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