Organization
BEHAVIORAL INDEPENDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMANDA ELLEN LANG BCBA (CEO)
(386) 562-0170
Entity
Organization
Contact information
Practice address
504 MOSELEY AVE, PALATKA, FL 32177-4937
(386) 562-0170
Mailing address
504 MOSELEY AVE, PALATKA, FL 32177-4937
(386) 562-0170
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-08-4879
FL
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/12/2017
Last updated
07/31/2026
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