Healthcare Provider Details

I. General information

NPI: 1689333189
Provider Name (Legal Business Name): JULIA M CHANCEY BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIA DOERR BCABA

II. Dates (important events)

Enumeration Date: 12/12/2021
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2748 S FALKENBURG RD STE 150
RIVERVIEW FL
33578-2561
US

IV. Provider business mailing address

2748 S FALKENBURG RD STE A
RIVERVIEW FL
33578-2561
US

V. Phone/Fax

Practice location:
  • Phone: 800-217-9289
  • Fax:
Mailing address:
  • Phone: 813-480-8191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2847430
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: