Provider Demographics
NPI:1932491461
Name:MAROT, MISTY FAITH (MA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:FAITH
Last Name:MAROT
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1980 N ATLANTIC AVE
Mailing Address - Street 2:SUITE 416
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-5213
Mailing Address - Country:US
Mailing Address - Phone:321-613-3823
Mailing Address - Fax:321-613-3824
Practice Address - Street 1:1980 N ATLANTIC AVE
Practice Address - Street 2:SUITE 416
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-5213
Practice Address - Country:US
Practice Address - Phone:321-613-3823
Practice Address - Fax:321-613-3824
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-03-1193103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst