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General NPI Number Information
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NPI Number | 1104586866
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Entity Type | Individual
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Provider Name | SAMANTHA ALEX APPLEBAUM BCBA
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Gender | Female
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 22169 CRESSMONT PL
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City | BOCA RATON
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State | FL
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Zip | 33428-4280
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Country | US
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Telephone | 561-463-8441
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Fax |
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Provider Business Mailing Address
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Address Line | 606 NE 8TH AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-4657
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Country | US
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Telephone | 561-715-6788
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-21-56292
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License Number State | FL
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