Healthcare Provider Details

I. General information

NPI: 1003232745
Provider Name (Legal Business Name): ALYSSA HEYER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2014
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 N HARBOR CITY BLVD
MELBOURNE FL
32935-6291
US

IV. Provider business mailing address

2740 N HARBOR CITY BLVD
MELBOURNE FL
32935-6291
US

V. Phone/Fax

Practice location:
  • Phone: 321-622-6884
  • Fax: 321-622-6842
Mailing address:
  • Phone: 321-622-6884
  • Fax: 321-622-6842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-63769
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: