Provider Demographics
NPI:1457873671
Name:HITCHCOCK, RICHARD T (BCBA)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:T
Last Name:HITCHCOCK
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 DESOTO PKWY
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3330
Mailing Address - Country:US
Mailing Address - Phone:321-795-9370
Mailing Address - Fax:
Practice Address - Street 1:265 DESOTO PKWY
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3330
Practice Address - Country:US
Practice Address - Phone:321-795-9370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician