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General NPI Number Information
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NPI Number | 1013244458
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Entity Type | Individual
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Provider Name | BRIDGET J CARON BCBA
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Gender | Female
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Dates
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Enumeration Date | 11/05/2009
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Last Update Date | 11/05/2009
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Provider Practice Location Address
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Address Line | 1409 KINGSLEY AVE STE 1C
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City | ORANGE PARK
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State | FL
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Zip | 32073-4532
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Country | US
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Telephone | 904-662-0289
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Fax |
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Provider Business Mailing Address
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Address Line | 100 FAIRWAY PARK BLVD UNIT 1008
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City | PONTE VEDRA BEACH
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State | FL
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Zip | 32082-2623
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Country | US
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Telephone | 904-662-0289
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Fax | 904-269-9667
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1073630
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License Number State | FL
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