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General NPI Number Information
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NPI Number | 1619677655
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Entity Type | Individual
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Provider Name | PAOLA COLLETTI ACOSTA
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Gender | Female
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Dates
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Enumeration Date | 03/08/2023
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 7600 DR PHILLIPS BLVD STE 72
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City | ORLANDO
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State | FL
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Zip | 32819-7238
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Country | US
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Telephone | 407-730-5969
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Fax |
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Provider Business Mailing Address
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Address Line | 516 VILLA DEL SOL CIR APT 202
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City | ORLANDO
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State | FL
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Zip | 32824-9462
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Country | US
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Telephone | 407-364-9029
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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 | 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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