Healthcare Provider Details

I. General information

NPI: 1699610030
Provider Name (Legal Business Name): HOPE N CAMPBELL BEHAVIOR TECHNICIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 E MELBOURNE AVE STE D
MELBOURNE FL
32901-5976
US

IV. Provider business mailing address

1512 MANOR DR NE
PALM BAY FL
32905-3154
US

V. Phone/Fax

Practice location:
  • Phone: 321-677-2222
  • Fax: 321-225-6772
Mailing address:
  • Phone: 321-216-1892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: