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General NPI Number Information
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NPI Number | 1013639772
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Entity Type | Organization
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Legal Business Name | LOTUS BEHAVIOR SOLUTIONS
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 01/01/2025
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Provider Practice Location Address
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Address Line | 421 WINDRUSH BAY DR
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-1205
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Country | US
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Telephone | 727-412-1007
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Fax |
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Provider Business Mailing Address
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Address Line | 421 WINDRUSH BAY DR
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-1205
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Country | US
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Telephone | 727-412-1007
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Fax |
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Authorized Official
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Title or Position | BCBA
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Name | KELLY FLYNN
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Credential |
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Telephone | 727-412-1007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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