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General NPI Number Information
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NPI Number | 1164138277
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Entity Type | Organization
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Legal Business Name | MISS B'S BEHAVIORAL SERVICES
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 1590 9TH ST SW
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City | VERO BEACH
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State | FL
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Zip | 32962-4311
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Country | US
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Telephone | 772-713-4130
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Fax |
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Provider Business Mailing Address
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Address Line | 4736 34TH AVE
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City | VERO BEACH
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State | FL
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Zip | 32967-1234
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Country | US
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Telephone | 772-584-6227
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LATOYA M. BULLARD
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Credential | BA
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Telephone | 772-713-4130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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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 | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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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 | 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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