Provider Demographics
NPI:1053912642
Name:RENDLER, YITTA (BCBA)
Entity type:Individual
Prefix:
First Name:YITTA
Middle Name:
Last Name:RENDLER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6911 ENVIRON BLVD APT 3K
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4242
Mailing Address - Country:US
Mailing Address - Phone:718-864-8148
Mailing Address - Fax:
Practice Address - Street 1:6911 ENVIRON BLVD APT 3K
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-4242
Practice Address - Country:US
Practice Address - Phone:718-864-8148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108139300Medicaid