Evanise Pericles, RBT
Behavior Technician in Orlando, FL. Individual provider (NPI-1).
NPI number1205429511
StatusActive
Last updated in NPPESFeb 17, 2021
Details
- NPI
- 1205429511
- Entity type
- Individual (NPI-1)
- Name
- Evanise Pericles
- Credential
- RBT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 17, 2021
- Certification date
- Feb 17, 2021
- Last updated
- Feb 17, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
644 Ferguson Dr Ste 200Orlando, FL 32805-1023
Phone 407-574-4629
Mailing address
6739 Meritmoor CirOrlando, FL 32818-2288
Phone 407-272-6533
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