Individual
ALECIA BRANTUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
285 E ALFRED ST STE B, TAVARES, FL 32778-3207
(352) 617-4113
Mailing address
285 E ALFRED ST STE B, TAVARES, FL 32778-3207
(352) 617-4113
(352) 849-0500
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
20120266
FL
106S00000X
Behavior Technician
Primary
—
FL
Other
Enumeration date
08/26/2021
Last updated
04/08/2026
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