Healthcare Provider Details

I. General information

NPI: 1881820496
Provider Name (Legal Business Name): ROBIN LATRELLE WILLIAMS MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12702 SCIENCE DR
ORLANDO FL
32826-3016
US

IV. Provider business mailing address

11713 OTTAWA AVE
ORLANDO FL
32837-7723
US

V. Phone/Fax

Practice location:
  • Phone: 407-574-2073
  • Fax:
Mailing address:
  • Phone: 407-758-3035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-05-2284
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: