Provider Demographics
NPI:1508426255
Name:MCBRIDE, ANNA CATHERINE (BCBA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:CATHERINE
Last Name:MCBRIDE
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 1:2629 ALGONQUIN AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-5903
Mailing Address - Country:US
Mailing Address - Phone:904-465-0090
Mailing Address - Fax:904-212-1032
Practice Address - Street 1:2629 ALGONQUIN AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-5903
Practice Address - Country:US
Practice Address - Phone:904-465-0090
Practice Address - Fax:904-212-1032
Is Sole Proprietor?:No
Enumeration Date:2019-06-15
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-17-43820106S00000X
FL1-22-58383103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician