Healthcare Provider Details

I. General information

NPI: 1801323035
Provider Name (Legal Business Name): MS. LYNN ST. HILAIRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2017
Last Update Date: 05/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 S HUNT CLUB BLVD
APOPKA FL
32703-4948
US

IV. Provider business mailing address

300 INTERNATIONAL PKWY STE 200
LAKE MARY FL
32746-5028
US

V. Phone/Fax

Practice location:
  • Phone: 407-613-2335
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-17-8210
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: