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General NPI Number Information
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NPI Number | 1609006501
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Entity Type | Individual
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Provider Name | CHERYL REISER
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Gender | Female
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Dates
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Enumeration Date | 07/26/2009
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 3408 S ATLANTIC AVE # 1052
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City | DAYTONA BEACH SHORES
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State | FL
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Zip | 32118-6311
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Country | US
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Telephone | 386-767-3719
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Fax | 386-767-4319
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Provider Business Mailing Address
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Address Line | 3408 S ATLANTIC AVE # 1052
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City | DAYTONA BEACH SHORES
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State | FL
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Zip | 32118-6311
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Country | US
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Telephone | 386-767-3719
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Fax | 386-767-4319
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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 | 03-31-2000
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License Number State | FL
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