Provider Demographics
NPI:1992488290
Name:PELLEGRINO, DANYELLA (RBT)
Entity type:Individual
Prefix:
First Name:DANYELLA
Middle Name:
Last Name:PELLEGRINO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4374 DAVOS DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5502
Mailing Address - Country:US
Mailing Address - Phone:239-699-7812
Mailing Address - Fax:
Practice Address - Street 1:4374 DAVOS DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-5502
Practice Address - Country:US
Practice Address - Phone:239-699-7812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-11
Last Update Date:2023-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-290088106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician