Kassidy Wynn
Individual provider Active NPI Behavior Technician · Lake Mary, FL
NPI 1265305486 · NPPES record last updated Sep 24, 2025
Key facts
- NPI
- 1265305486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 300 International Pkwy Ste 200
Lake Mary, FL 32746-5028 - Phone
- (866) 610-0580
- Fax
- (866) 611-1558
- NPI assigned
- Sep 24, 2025
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | FL | Yes |
Addresses
Primary practice location
300 International Pkwy Ste 200
Lake Mary, FL 32746-5028
Mailing address
300 International Pkwy Ste 200
Lake Mary, FL 32746-5028
Phone (866) 610-0580
Other providers in Lake Mary, FL
- Laurie L Wren
- Adekia Brianna Wright
- Catherine Wright
- Jalisa Wright
- Ping Wu
- Wynne Chiropractic Inc.
- Kevin G Wynne
- Daniel S Yachter
- Effie C Yao
- Pamela Leann Yarrington
All providers in Lake Mary, FL · Behavior Technician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.