Provider Demographics
NPI:1134590615
Name:CRANMER, DELILAH (MS, LBS, BCBA)
Entity type:Individual
Prefix:
First Name:DELILAH
Middle Name:
Last Name:CRANMER
Suffix:
Gender:F
Credentials:MS, LBS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 MIDDLE ST UNIT 1201
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3625
Mailing Address - Country:US
Mailing Address - Phone:866-610-0580
Mailing Address - Fax:407-588-6294
Practice Address - Street 1:247 SW PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34984-5015
Practice Address - Country:US
Practice Address - Phone:772-207-1356
Practice Address - Fax:772-742-2924
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-09
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002882103K00000X
FL1-18-32460103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst