Mary Anna Buckner, RBT-18-73005

Individual provider Active NPI Behavior Technician · Bunnell, FL

NPI 1356808661 · NPPES record last updated Feb 22, 2019

Key facts

NPI
1356808661
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-18-73005 (FL)
Practice address
1288 Hazelnut St
Bunnell, FL 32110-6732
Phone
(386) 864-9391
Fax
(386) 226-2076
NPI assigned
Feb 22, 2019
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

State licenses

LicenseStateTypeSpecialty
RBT-18-73005FLMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-18-73005 FL Yes

Addresses

Primary practice location

1288 Hazelnut St
Bunnell, FL 32110-6732

Mailing address

1288 Hazelnut St
Bunnell, FL 32110-6732
Phone (386) 864-9391

Other providers in Bunnell, FL

All providers in Bunnell, FL · Behavior Technician in Florida

Sources for this page

Verify at the official NPI Registry.