Provider Demographics
NPI:1003453614
Name:STRICKLAND, PAIGE (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 E LAKE SUE AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-5903
Mailing Address - Country:US
Mailing Address - Phone:321-439-0966
Mailing Address - Fax:
Practice Address - Street 1:140 ADVANCE PT
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-3422
Practice Address - Country:US
Practice Address - Phone:321-316-4860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-19-36644103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty