Organization
CREATIVE LEARNING INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHRYN MENDOZA BCBA,ED.D. (DIRECTOR)
(321) 243-5284
Entity
Organization
Contact information
Practice address
453 KING ST, COCOA, FL 32922-7621
(321) 633-5511
Mailing address
453 KING ST, COCOA, FL 32922-7621
(321) 633-5511
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016568500
—
FL
Enumeration date
12/01/2015
Last updated
10/01/2020
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