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General NPI Number Information
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NPI Number | 1205649845
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Entity Type | Individual
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Provider Name | MAXWELL MILLER DAHM
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Gender | Male
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 7594 W SAND LAKE RD
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City | ORLANDO
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State | FL
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Zip | 32819-5188
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Country | US
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Telephone | 800-875-1871
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Fax |
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Provider Business Mailing Address
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Address Line | 889 S LAKE JESSUP AVE
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City | OVIEDO
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State | FL
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Zip | 32765-9301
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Country | US
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Telephone | 321-578-2100
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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 | 0-25-15791
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License Number State | FL
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