Provider Demographics
NPI:1447506803
Name:O'NEILL, ROSANA PESANTEZ (BCBA)
Entity type:Individual
Prefix:
First Name:ROSANA
Middle Name:PESANTEZ
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ROSANA
Other - Middle Name:
Other - Last Name:PESANTEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:7418 10TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-5104
Mailing Address - Country:US
Mailing Address - Phone:727-526-3905
Mailing Address - Fax:727-527-8904
Practice Address - Street 1:7418 10TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-5104
Practice Address - Country:US
Practice Address - Phone:727-526-3905
Practice Address - Fax:727-527-8904
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0125056103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst