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NPI Code Detail

MEDICARE: KIMBERLY EDWARDS BCBA

MEDICARE: KIMBERLY EDWARDS 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
1251C00000XDevelopmentally Disabled Services Day Training Agency
2251S00000XCommunity/Behavioral Health Agency
3252Y00000XEarly Intervention Provider Agency
4103K00000XBehavior Analyst1-18-33584GA

General Provider Information

NPI Number : 1629399795
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY EDWARDS BCBA
Provider Business Mailing Address
First Line : 300 INTERNATIONAL PKWY STE 200
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-5028
Country : US
Telephone Number : 866-610-0580
Fax Number : 407-588-6294
Provider Business Practice Location Address
First Line : 2227 GODBY RD
Second Line :
City : ATLANTA
State : GA
Zip : 30349-5020
Country : US
Telephone Number : 888-975-4557
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2010
Last Update Date : 05/05/2025

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Directions to “ KIMBERLY EDWARDS BCBA” Practice Location

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