Healthcare Provider Details

I. General information

NPI: 1679596084
Provider Name (Legal Business Name): CHILD AND FAMILY CONSULTANTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 PENN ST STE 12
MELBOURNE FL
32901-2625
US

IV. Provider business mailing address

1800 PENN ST STE 12
MELBOURNE FL
32901-2625
US

V. Phone/Fax

Practice location:
  • Phone: 321-768-6800
  • Fax: 321-768-6858
Mailing address:
  • Phone: 321-768-6800
  • Fax: 321-768-6858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: VALERIE M PALMER
Title or Position: OFFICE MANAGER
Credential:
Phone: 321-768-6800