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NPI Code Detail

MEDICARE: COURTNEY FORD BCBA

MEDICARE: COURTNEY FORD BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst0-16-7143CO

General Provider Information

NPI Number : 1376996033
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY FORD BCBA
Provider Business Mailing Address
First Line : 10256 CLASSIC OAK RD N
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32225-9031
Country : US
Telephone Number : 904-486-8230
Fax Number :
Provider Business Practice Location Address
First Line : 8001 BEATY GROVE DR
Second Line :
City : TAMPA
State : FL
Zip : 33626-1602
Country : US
Telephone Number : 904-486-8230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2016
Last Update Date : 10/01/2021

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Directions to “ COURTNEY FORD BCBA” Practice Location

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