Healthcare Provider Details

I. General information

NPI: 1114640265
Provider Name (Legal Business Name): OWNLIGHTS ABA SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2022
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 SW 20TH ST
CAPE CORAL FL
33991-3202
US

IV. Provider business mailing address

1221 SW 20TH ST
CAPE CORAL FL
33991-3202
US

V. Phone/Fax

Practice location:
  • Phone: 786-403-4105
  • Fax:
Mailing address:
  • Phone: 786-403-4105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: LISET RODRIGUEZ MARRERO
Title or Position: PRESIDENT
Credential: BCBA
Phone: 786-403-4105