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NPI Code Detail

MEDICARE: ALLISON MOLLENGARDEN

MEDICARE: ALLISON MOLLENGARDEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1053869388
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON MOLLENGARDEN
Provider Business Mailing Address
First Line : 1110 MEADOWS AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32804-2122
Country : US
Telephone Number : 727-656-3732
Fax Number :
Provider Business Practice Location Address
First Line : 11476 S APOPKA VINELAND RD
Second Line :
City : ORLANDO
State : FL
Zip : 32836-7006
Country : US
Telephone Number : 407-955-4001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2016
Last Update Date : 09/15/2016

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Directions to “ ALLISON MOLLENGARDEN ” Practice Location

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