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Christine Tracy Fishero-Fazio, BCBA

Behavior Analyst in Port St Joe, FL. Individual provider (NPI-1).

NPI number1760622385
StatusActive
Last updated in NPPESApr 18, 2016

Details

NPI
1760622385
Entity type
Individual (NPI-1)
Name
Christine Tracy Fishero-Fazio
Credential
BCBA
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 22, 2009
Last updated
Apr 18, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103K00000X Behavior Analyst10-06-3112FLYes

Practice location

1321 McClelland Ave
Port St Joe, FL 32456-2041

Phone 850-227-4392 · Fax 850-229-6166

Mailing address

3076 Anderson Rd
Green Cove Springs, FL 32043-9301

Phone 850-227-4392

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