Provider Demographics
NPI:1396133948
Name:ROBERTS, AIMEE (BCBA)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:751 RHODEN COVE RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-1013
Mailing Address - Country:US
Mailing Address - Phone:803-381-3309
Mailing Address - Fax:850-344-9900
Practice Address - Street 1:510 W 10TH ST
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-2329
Practice Address - Country:US
Practice Address - Phone:850-815-8800
Practice Address - Fax:850-344-9900
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-06
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-15-20959103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst