Healthcare Provider Details

I. General information

NPI: 1477870517
Provider Name (Legal Business Name): ALMA T BIRD MA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 PENNSYLVANIA AVE
SAINT CLOUD FL
34769-3371
US

IV. Provider business mailing address

232 ALABAMA AVE
SAINT CLOUD FL
34769-2131
US

V. Phone/Fax

Practice location:
  • Phone: 321-805-4426
  • Fax: 407-902-0019
Mailing address:
  • Phone: 407-301-3791
  • Fax: 407-902-0019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-2139
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: