Healthcare Provider Details

I. General information

NPI: 1992424204
Provider Name (Legal Business Name): B&D BEHAVIORAL SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 10TH AVE N STE 5A
LAKE WORTH FL
33461-6605
US

IV. Provider business mailing address

2311 10TH AVE N STE 5A
LAKE WORTH FL
33461-6605
US

V. Phone/Fax

Practice location:
  • Phone: 561-385-0085
  • Fax:
Mailing address:
  • Phone: 561-385-0085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MRS. BLYDA ARRECHEA CORUNA
Title or Position: PRESIDENT
Credential: MS, BCBA
Phone: 239-440-9787