Healthcare Provider Details

I. General information

NPI: 1083247043
Provider Name (Legal Business Name): FLYNN BEHAVIORAL AND EDUCATIONAL CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2020
Last Update Date: 07/24/2021
Certification Date: 07/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3576 CANARY PALM CT
POMPANO BEACH FL
33069-6118
US

IV. Provider business mailing address

3576 CANARY PALM CT # 296
POMPANO BEACH FL
33069-6118
US

V. Phone/Fax

Practice location:
  • Phone: 508-942-6506
  • Fax:
Mailing address:
  • Phone: 508-942-6506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MS. SUMNER R FLYNN
Title or Position: OWNER
Credential:
Phone: 508-942-6506