Healthcare Provider Details

I. General information

NPI: 1306125893
Provider Name (Legal Business Name): BHC ASSESSMENT & CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2011
Last Update Date: 08/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N MAGNOLIA AVE STE 314
ORLANDO FL
32803-3843
US

IV. Provider business mailing address

801 N MAGNOLIA AVE STE 314
ORLANDO FL
32803-3843
US

V. Phone/Fax

Practice location:
  • Phone: 407-963-5664
  • Fax: 407-896-0037
Mailing address:
  • Phone: 407-963-5664
  • Fax: 407-896-0037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberMH6562
License Number StateFL

VIII. Authorized Official

Name: DR. DAVID BAKER-HARGROVE
Title or Position: PYSCHOTHERPIST
Credential:
Phone: 407-963-5664