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Individual

ALYSSA MYCHAELA WEEKLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RBT

Contact information

Practice address
128 JOHN KING RD STE 18, CRESTVIEW, FL 32539-5731
(850) 585-9189
(850) 951-0898
Mailing address
40 ST HWY 83 N, DEFUNIAK SPRINGS, FL 32433-7404
(850) 585-9189
(850) 951-0898

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-123009

Other

Enumeration date
06/10/2020
Last updated
06/10/2020
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