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General NPI Number Information
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NPI Number | 1255039830
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Entity Type | Organization
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Legal Business Name | EMPOWERING MINDS BEHAVIORAL SERVICES LLC
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 03/18/2023
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Provider Practice Location Address
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Address Line | 6230 LAPIS LN
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City | CRESTVIEW
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State | FL
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Zip | 32539-5425
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Country | US
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Telephone | 850-400-6098
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Fax | 866-265-8817
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Provider Business Mailing Address
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Address Line | 6230 LAPIS LN
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City | CRESTVIEW
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State | FL
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Zip | 32539-5425
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Country | US
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Telephone | 850-333-3103
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Fax |
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Authorized Official
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Title or Position | BCBA
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Name | MRS. NATASHA PERRY
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Credential | M.A.
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Telephone | 850-333-3103
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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 |
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License Number State |
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