Healthcare Provider Details

I. General information

NPI: 1982518841
Provider Name (Legal Business Name): CITRUS AUTISM BEHAVIORAL ADVOCATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10133 W VERONA CIR
VERO BEACH FL
32966-3129
US

IV. Provider business mailing address

10133 W VERONA CIR
VERO BEACH FL
32966-3129
US

V. Phone/Fax

Practice location:
  • Phone: 732-664-0577
  • Fax:
Mailing address:
  • Phone: 732-664-0577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: JILLIAN ELAINE THIEL
Title or Position: BCBA/OWNER
Credential: BCBA
Phone: 732-664-0577