Provider / Organization | NPI | Date Certified |
---|---|---|
JONATHAN TED WALTON | 1417540188 | 2021-02-14 |
Jonathan Ted Walton is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1417540188. Registration indicates Jonathan Ted Walton is a provider of services with a specialization in Behavioral Health & Social Service Providers, Behavior Technician (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, )
Entity Type | Individual |
Provider Name | Jonathan Ted Walton |
Practice Office Address | 202 HOWARD ST STE 3 AUBURNDALE, FL US |
Practice Office Telephone | 8635513300 |
Mailing Address | PO BOX 1057 LAKE ALFRED, FL 338501057 US |
Code | Practice | License No State |
---|---|---|
106S00000X PRIMARY | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician | RBT-20-148238
FL |