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General NPI Number Information
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NPI Number | 1184598518
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Entity Type | Organization
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Legal Business Name | WILLOW PATH ABA & LEARNING LC
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 626 N ALAFAYA TRL STE 206 PMB1014
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City | ORLANDO
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State | FL
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Zip | 32828-4353
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Country | US
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Telephone | 689-326-7019
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Fax |
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Provider Business Mailing Address
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Address Line | 626 N ALAFAYA TRL STE 206 PMB1014
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City | ORLANDO
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State | FL
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Zip | 32828-4353
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ BEHAVIOR ANALYST
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Name | TIFFANY MEDINA
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Credential | M.A, BCBA/LBA
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Telephone | 689-326-7019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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