Provider Demographics
NPI:1821568312
Name:ORTIZ DAVILA, LYDIA E (BCBA)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:E
Last Name:ORTIZ DAVILA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8746 CLAIBORNE CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-3498
Mailing Address - Country:US
Mailing Address - Phone:407-300-1171
Mailing Address - Fax:
Practice Address - Street 1:8746 CLAIBORNE CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-3498
Practice Address - Country:US
Practice Address - Phone:407-300-1171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-28
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician