Ketzlick, Alyssa

Ketzlick, Alyssa is an sole proprietor health care provider with primary practice located at 1532 Sw Mapp Rd , Palm City FL 34990-2446. She recently has 2 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Technician, Other, Behavioral Health & Social Service Providers / Behavior Technician. Behavioral Health & Social Service Providers / Behavior Technician is her primary health care specialty. Ketzlick, Alyssa can be contacted via phone (772) 678-6704.

Contact Information

Primary practice address
1532 Sw Mapp Rd Palm City FL 34990-2446
Phone: (772) 678-6704
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Technician, Other 247200000X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X RBT-16-19246 Florida

Profile Details

NPI number 1144622887
LBN Legal business name Ketzlick, Alyssa
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 25th, 2014
Last updated Dec 12th, 2022 - about 2 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 1144622887 NPPES
Florida MEDICAID 018543800

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