Healthcare Provider Details

I. General information

NPI: 1407190382
Provider Name (Legal Business Name): MAIA LYNN BURNARD BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2012
Last Update Date: 12/07/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7441 114TH AVE STE 604
LARGO FL
33773-5124
US

IV. Provider business mailing address

7441 114TH AVE STE 604
LARGO FL
33773-5124
US

V. Phone/Fax

Practice location:
  • Phone: 727-492-5369
  • Fax:
Mailing address:
  • Phone: 727-492-5369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-44048
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: