Provider Demographics
NPI:1821549320
Name:OTTANI, APRIL DAWN (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:DAWN
Last Name:OTTANI
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:
Other - Last Name:SHIZAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12585 FLAGLER CENTER BLVD APT 2109
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-2634
Mailing Address - Country:US
Mailing Address - Phone:410-829-7078
Mailing Address - Fax:
Practice Address - Street 1:124 CAPULET DR STE 102
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-4538
Practice Address - Country:US
Practice Address - Phone:904-429-3859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106E00000X
0-18-33872103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst