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General NPI Number Information
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NPI Number | 1053991968
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Entity Type | Individual
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Provider Name | INGRID HOULIHAN
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Gender | Female
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 5180 W ATLANTIC AVE STE 112
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8103
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Country | US
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Telephone | 53-244-0648
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Fax |
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Provider Business Mailing Address
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Address Line | 18008 JAZZ LN
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City | BOCA RATON
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State | FL
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Zip | 33496-4108
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Country | US
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Telephone | 305-244-0648
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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