Individual
KIRA PATRICIA OMEALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2106 LINDA SUE CIRCLE #105, FORT PIERCE, FL 34982
(772) 634-5403
Mailing address
2106 LINDA SUE CIR APT 105, FORT PIERCE, FL 34982-6162
(772) 634-5403
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
—
FL
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018834400
—
FL
Enumeration date
06/15/2017
Last updated
07/21/2022
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