Provider Demographics
NPI:1376191411
Name:BORDONI, ALYSSA F (RBT)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:F
Last Name:BORDONI
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17826 RABBIT FARM RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34610-7412
Mailing Address - Country:US
Mailing Address - Phone:850-461-2667
Mailing Address - Fax:
Practice Address - Street 1:11820 MUNBURY DR
Practice Address - Street 2:
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33525-5747
Practice Address - Country:US
Practice Address - Phone:352-999-0447
Practice Address - Fax:352-437-4921
Is Sole Proprietor?:No
Enumeration Date:2019-09-02
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-90162106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician