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General NPI Number Information
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NPI Number | 1114768009
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Entity Type | Individual
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Provider Name | JOSEPH ESSUE RBT, EMT
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Gender | Male
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 319 W OAK ST
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City | KISSIMMEE
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State | FL
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Zip | 34741-4421
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Country | US
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Telephone | 407-895-0801
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Fax |
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Provider Business Mailing Address
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Address Line | 611 BROCKTON DR
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City | KISSIMMEE
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State | FL
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Zip | 34758-4203
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Country | US
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Telephone | 860-881-6406
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Fax |
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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 | RBT-23-285828
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License Number State | CT
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