Ann Marie Wanliss, MS ITDS, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-20-46414 Issued in CO

Practice address

9376 NW 54TH St
Sunrise, FL 33351-7788

Phone

(954) 652-8613

NPI assigned

Jun 14, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• N/a N/a Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vital Skills Center LLC

  • Behavior Analyst
  • Sunrise, FL
  • NPI 1912467788
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1023339074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9376 NW 54TH ST",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333517788",
            "telephone_number": "954-652-8613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9376 NW 54TH ST",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333517788",
            "telephone_number": "954-652-8613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANLISS",
        "first_name": "ANN MARIE",
        "name_prefix": "Ms.",
        "credential": "MS ITDS, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "1-20-46414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Luz Waterston

• Behavior Analyst in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.