Provider Demographics
NPI:1295894491
Name:ALTIERIMILLS, LYNETTE CHRIS (MS, BCBA)
Entity type:Individual
Prefix:MS
First Name:LYNETTE
Middle Name:CHRIS
Last Name:ALTIERIMILLS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16914 MELISSA ANN DRIVE
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558
Mailing Address - Country:US
Mailing Address - Phone:813-503-3599
Mailing Address - Fax:
Practice Address - Street 1:16914 MELISSA ANN DRIVE
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558
Practice Address - Country:US
Practice Address - Phone:813-503-3599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4994101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health