Healthcare Provider Details

I. General information

NPI: 1497260814
Provider Name (Legal Business Name): SABRINA BESS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2017
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 E EDGEWOOD DR
LAKELAND FL
33803-4014
US

IV. Provider business mailing address

1513 CALDERA CT
CLEARWATER FL
33756-2397
US

V. Phone/Fax

Practice location:
  • Phone: 863-619-2809
  • Fax:
Mailing address:
  • Phone: 732-330-5640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: