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General NPI Number Information
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NPI Number | 1194392514
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Entity Type | Organization
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Legal Business Name | SIDE BY SIDE BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 06/04/2021
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Provider Practice Location Address
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Address Line | 2151 CONSULATE DR STE 11
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City | ORLANDO
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State | FL
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Zip | 32837-8806
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Country | US
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Telephone | 321-444-9527
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Fax | 407-641-9591
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Provider Business Mailing Address
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Address Line | 2151 CONSULATE DR STE 11
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City | ORLANDO
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State | FL
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Zip | 32837-8806
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Country | US
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Telephone | 321-444-9527
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Fax | 407-641-9591
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Authorized Official
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Title or Position | BCBA
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Name | PAULA NUNEZ GALETTO
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Credential |
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Telephone | 321-444-9527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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