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General NPI Number Information
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NPI Number | 1134777055
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Entity Type | Individual
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Provider Name | LIANA CHAMBLISS
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Gender | Female
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Dates
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Enumeration Date | 09/04/2019
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 500 NE SPANISH RIVER BLVD STE 31
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City | BOCA RATON
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State | FL
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Zip | 33431-4517
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Country | US
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Telephone | 561-563-3738
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 CONCORD AVE STE 185
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City | CONCORD
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State | CA
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Zip | 94520-5006
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Country | US
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Telephone | 510-268-8120
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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 | RBT-19-99463
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License Number State | FL
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-24-1538
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License Number State | FL
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