Healthcare Provider Details
I. General information
NPI: 1982266565
Provider Name (Legal Business Name): CHRISTOPHER LYTLE MS BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/03/2019
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2145 METROCENTER BLVD
ORLANDO FL
32835-7643
US
IV. Provider business mailing address
4620 N STATE ROAD 7 STE 300
LAUDERDALE LAKES FL
33319-5867
US
V. Phone/Fax
- Phone: 561-850-2773
- Fax:
- Phone: 615-323-6593
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: