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General NPI Number Information
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NPI Number | 1942897335
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Entity Type | Individual
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Provider Name | VASILY BELICHENKO
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Gender | Male
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Dates
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Enumeration Date | 12/31/2020
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Last Update Date | 11/03/2022
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Provider Practice Location Address
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Address Line | 3779 SILVER STAR RD
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City | ORLANDO
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State | FL
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Zip | 32808-4627
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Country | US
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Telephone | 407-399-7236
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Fax |
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Provider Business Mailing Address
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Address Line | 3779 SILVER STAR RD
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City | ORLANDO
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State | FL
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Zip | 32808-4627
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Country | US
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Telephone | 407-399-7236
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Fax | 407-386-7133
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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 | BACB557991
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License Number State | FL
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