Collins, Divvia-Clyne Ashley

Collins, Divvia-Clyne Ashley is an individual health care provider with primary practice located at 148 Wilshire Blvd , Casselberry FL 32707-5372. She recently has only one registered license in Behavioral Health & Social Service Providers / Assistant Behavior Analyst, which is considered as her primary health care specialty. Collins, Divvia-Clyne Ashley can be contacted via phone (321) 972-4039.

Contact Information

Primary practice address
148 Wilshire Blvd Casselberry FL 32707-5372
Phone: (321) 972-4039
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Assistant Behavior Analyst 106E00000X 0-17-7834 Florida

Profile Details

NPI number 1194297424
LBN Legal business name Collins, Divvia-Clyne Ashley
Credentials BCABA
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2018
Last updated Apr 8th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194297424 NPPES
Florida MEDICAID 018980700

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