Amanda Bances Broche

Individual provider Active NPI Behavior Analyst · Lauderhill, FL

NPI 1104414796 · NPPES record last updated Oct 24, 2024

Key facts

NPI
1104414796
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
BCBA-1-22-62910 (FL)
Practice address
4420 NW 11TH St
Lauderhill, FL 33313
Phone
(786) 813-2941
NPI assigned
Jan 8, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BCBA-1-22-62910 FL Yes
Assistant Behavior Analyst 106E00000X 0-20-11431 FL

Addresses

Primary practice location

4420 NW 11TH St
Lauderhill, FL 33313

Mailing address

4420 NW 11TH St
Lauderhill, FL 33313
Phone (786) 813-2941

Other identifiers

IdentifierTypeStateIssuer
108669800MedicaidFL

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address amanda.bances@victorybrt.com

Other providers in Lauderhill, FL

All providers in Lauderhill, FL · Behavior Analyst in Florida

Sources for this page

Verify at the official NPI Registry.