Individual
ANGELA K POTUCEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5830 US HIGHWAY 1, ROCKLEDGE, FL 32955-5761
(216) 099-0073
Mailing address
125 E NASA BLVD, MELBOURNE, FL 32901-1900
(321) 345-4232
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-05-1917
FL
Other
Enumeration date
08/17/2011
Last updated
09/02/2025
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