Provider Demographics
NPI:1497201982
Name:RICHARDS, MIA (BCBA)
Entity Type:Individual
Prefix:
First Name:MIA
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6903 SAWTOOTH CT
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-8451
Mailing Address - Country:US
Mailing Address - Phone:407-758-4948
Mailing Address - Fax:
Practice Address - Street 1:6903 SAWTOOTH CT
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-8451
Practice Address - Country:US
Practice Address - Phone:407-758-4948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst