Kianza Stephanie Black
Behavior Technician in Orlando, FL. Individual provider (NPI-1).
NPI number1295412641
StatusActive
Last updated in NPPESJun 28, 2023
Details
- NPI
- 1295412641
- Entity type
- Individual (NPI-1)
- Name
- Kianza Stephanie Black
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 28, 2023
- Certification date
- Jun 28, 2023
- Last updated
- Jun 28, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
5959 Lake Ellenor DrOrlando, FL 32809-4633
Phone 321-972-4039
Mailing address
5959 Lake Ellenor DrOrlando, FL 32809-4633
Phone 321-972-4039
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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