Provider Demographics
NPI:1174768055
Name:STOVER, ANTHONY CHARLES (MA, BCBA)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:CHARLES
Last Name:STOVER
Suffix:
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 77TH AVE N STE 56546
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-5299
Mailing Address - Country:US
Mailing Address - Phone:727-403-6171
Mailing Address - Fax:
Practice Address - Street 1:701 77TH AVE N STE 56546
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-5299
Practice Address - Country:US
Practice Address - Phone:727-403-6171
Practice Address - Fax:727-346-5579
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-04-1699103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst