Provider Demographics
NPI:1336895259
Name:MCCOY, ANTHONY BERNARD JR (RBT)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:BERNARD
Last Name:MCCOY
Suffix:JR
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13806 STATE ROAD 33
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:FL
Mailing Address - Zip Code:34736-9499
Mailing Address - Country:US
Mailing Address - Phone:352-874-0639
Mailing Address - Fax:
Practice Address - Street 1:13806 STATE ROAD 33
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:FL
Practice Address - Zip Code:34736-9499
Practice Address - Country:US
Practice Address - Phone:352-874-0639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician