Basic Information
| Provider Information | |||||||||
| NPI: | 1538561352 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRANCESCONI | ||||||||
| FirstName: | STACEY | ||||||||
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| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10175 FORTUNE PARKWAY | ||||||||
| Address2: | SUITE 903 | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9045380713 | ||||||||
| FaxNumber: | 9045380714 | ||||||||
| Practice Location | |||||||||
| Address1: | 15 PACELLA PARK DR STE 210 | ||||||||
| Address2: | |||||||||
| City: | RANDOLPH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02368 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9787373760 | ||||||||
| FaxNumber: | 3178153861 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2014 | ||||||||
| LastUpdateDate: | 03/22/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.