Healthcare Provider Details

I. General information

NPI: 1467112441
Provider Name (Legal Business Name): RYAN HINDERLITER BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2021
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 3RD AVE N UNIT 414
SAINT PETERSBURG FL
33701-3378
US

IV. Provider business mailing address

235 3RD AVE N UNIT 414
SAINT PETERSBURG FL
33701-3378
US

V. Phone/Fax

Practice location:
  • Phone: 908-514-2212
  • Fax:
Mailing address:
  • Phone: 908-514-2212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-24-14970
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-82255
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: