Individual
HOPE NULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
318 HONEY BEAR DR, MYRTLE BEACH, SC 29588-8829
(407) 773-2390
Mailing address
121 N HIGHLAND ST, MOUNT DORA, FL 32757-5764
(352) 720-5194
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-65001
FL
Other
Enumeration date
12/12/2019
Last updated
06/18/2024
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