Individual
BREANNE BAEZ-COLANTONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
125 E NASA BLVD, MELBOURNE, FL 32901
(321) 372-6813
(321) 765-6434
Mailing address
125 E NASA BLVD, MELBOURNE, FL 32901-1900
(321) 372-6813
(321) 765-6434
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-32565
FL
106S00000X
Behavior Technician
RBT-17-41823
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022112800
—
FL
Enumeration date
07/13/2016
Last updated
10/01/2018
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