Healthcare Provider Details

I. General information

NPI: 1679820021
Provider Name (Legal Business Name): JENNIFER TORPY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2012
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2062 N COURTENAY PKWY
MERRITT ISLAND FL
32953-4285
US

IV. Provider business mailing address

468 BIMINI LN
INDIAN HARBOUR BEACH FL
32937-4411
US

V. Phone/Fax

Practice location:
  • Phone: 321-305-5576
  • Fax: 321-305-5646
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0-12-5023
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: