Healthcare Provider Details

I. General information

NPI: 1619398385
Provider Name (Legal Business Name): ACHIEVEABILITY THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2013
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18288 N US HWY 41
LUTZ FL
33549
US

IV. Provider business mailing address

18288 N. US HIGHWAY 41
LUTZ FL
33549
US

V. Phone/Fax

Practice location:
  • Phone: 813-527-9638
  • Fax: 813-867-7288
Mailing address:
  • Phone: 813-527-9638
  • Fax: 813-867-7288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY FAYE HULL
Title or Position: OWNER
Credential: MS, CCC/SLP, BCBA
Phone: 813-527-9638