Healthcare Provider Details

I. General information

NPI: 1033656426
Provider Name (Legal Business Name): CHRISTINA ROSE GRECO M.A., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2017
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5959 LAKE ELLENOR DR
ORLANDO FL
32809-4633
US

IV. Provider business mailing address

5959 LAKE ELLENOR DR
ORLANDO FL
32809-4633
US

V. Phone/Fax

Practice location:
  • Phone: 321-972-4039
  • Fax:
Mailing address:
  • Phone: 321-972-4039
  • 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:
Title or Position:
Credential:
Phone: