Provider Demographics
NPI:1043961295
Name:CARPENTER, ANNA K (RBT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:K
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4404 RING NECK RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-2055
Mailing Address - Country:US
Mailing Address - Phone:412-335-6112
Mailing Address - Fax:
Practice Address - Street 1:4964 N PALM AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-9111
Practice Address - Country:US
Practice Address - Phone:321-228-3765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21191426106S00000X
FL1-24-76939103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician