Individual
AMANDA RUTH STOCKDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 MANATEE XING APT 306, DAYTONA BEACH, FL 32119-1479
(412) 496-9059
Mailing address
PO BOX 731624, ORMOND BEACH, FL 32173-1624
(412) 496-9059
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-113858
FL
106S00000X
Behavior Technician
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Other
Enumeration date
05/06/2020
Last updated
05/06/2020
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