Provider Demographics
NPI:1730319120
Name:SCALZO, RACHEL ANN (BCBA-D)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:SCALZO
Suffix:
Gender:F
Credentials:BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 DUNWOODY LN
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2952
Mailing Address - Country:US
Mailing Address - Phone:315-559-4428
Mailing Address - Fax:
Practice Address - Street 1:100 DUNWOODY LN
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-2952
Practice Address - Country:US
Practice Address - Phone:315-559-4428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-15-18433103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst