Healthcare Provider Details

I. General information

NPI: 1629644687
Provider Name (Legal Business Name): DIRECT BEHAVIORAL STRATEGIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 06/01/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 PARK PLACE BLVD
KISSIMMEE FL
34741-2345
US

IV. Provider business mailing address

508 LEGACY PARK DR
CASSELBERRY FL
32707-2402
US

V. Phone/Fax

Practice location:
  • Phone: 407-968-8349
  • Fax: 407-264-6443
Mailing address:
  • Phone: 407-968-8349
  • Fax: 407-264-6443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ROBIN NICOLE QUINN
Title or Position: OWNER
Credential: BCBA
Phone: 407-968-8349