Provider Demographics
NPI:1083005003
Name:DEBENEDITTIS, KAYLA (MS, BCBA)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:DEBENEDITTIS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 MONUMENT AVE SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-8510
Mailing Address - Country:US
Mailing Address - Phone:321-271-0455
Mailing Address - Fax:
Practice Address - Street 1:1280 MONUMENT AVE SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-8510
Practice Address - Country:US
Practice Address - Phone:321-271-0455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-20-40837103K00000X
103K00000X
FL0-16-7550106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst