Provider Demographics
NPI:1174175418
Name:ANOCETO MARCET, DIANELIS (BCBA)
Entity type:Individual
Prefix:
First Name:DIANELIS
Middle Name:
Last Name:ANOCETO MARCET
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 1:1605 RUTLEDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:FL
Mailing Address - Zip Code:33852-7296
Mailing Address - Country:US
Mailing Address - Phone:305-763-7361
Mailing Address - Fax:
Practice Address - Street 1:8910 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1591
Practice Address - Country:US
Practice Address - Phone:813-773-6569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-16
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-20-46648103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty