MYDRIS BOLTZE
NPI 1609412295
Behavior Technician in Jacksonville, FL

Q: What is Mydris Boltze's NPI number?

The NPI number for Mydris Boltze is 1609412295. It was assigned to this individual provider in the NPPES registry on November 19, 2019.

Q: What is Mydris Boltze's specialty?

The primary specialty registered for this NPI is Behavior Technician with taxonomy code 106S00000X.

Q: When was this NPI record last updated?

The NPPES record for Mydris Boltze was last updated on September 16, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since November 19, 2019

12724 GRAN BAY PKWY W STE 410, JACKSONVILLE, FL 32258(855) 832-6727 Get Directions Write a Review

NPPES record last updated: September 16, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 16, 2025, Nov 19, 2019 (2 updates tracked since 2019).

On this page

About Mydris Boltze NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MYDRIS BOLTZE (NPI 1609412295) is an individual behavior technician in Jacksonville, Florida and active in the NPI registry since November 2019.

NPPES Registry Identity

NPI1609412295

Entity TypeIndividualFemale

Primary Taxonomy106S00000X

Provider Legal NameMYDRIS BOLTZE

Location Address12724 GRAN BAY PKWY W STE 410Jacksonville, FL 32258-9486

Mailing Address7108 S Kanner HwyStuart, FL 34997-7462 · (855) 832-6727

Phone(855) 832-6727

Sole ProprietorNo

Enumeration DateNovember 19, 2019

Last NPPES UpdateSeptember 16, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 16, 2025

✔ NPI 1609412295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyBehavior TechnicianBehavioral Health & Social Service Providers

Taxonomy Code106S00000X

Definition

The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.

12724 GRAN BAY PKWY W STE 410, Jacksonville, FL 32258

Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANITA MORENO LISW

Social Worker (Clinical)