Organization
COLLABORATIVE CORNER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN BARISANO (BOARD OF DIRECTORS)
(321) 231-4856
Entity
Organization
Contact information
Practice address
16550 MORNINGSIDE DR, MONTVERDE, FL 34756-3231
(321) 231-4856
Mailing address
16550 MORNINGSIDE DR, MONTVERDE, FL 34756-3231
(321) 231-4856
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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