Individual
COREY L. ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., BCBA
Contact information
Practice address
2106 CARPATHIAN DR, APOPKA, FL 32712-4710
(407) 716-7569
Mailing address
2106 CARPATHIAN DR, APOPKA, FL 32712-4710
(407) 716-7569
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
693250996
—
FL
05
—
693250998
—
FL
Enumeration date
10/15/2009
Last updated
10/15/2009
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