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General NPI Number Information
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NPI Number | 1265868632
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Entity Type | Organization
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Legal Business Name | DEVELOPMENT BEHAVIOR SOLUTIONS, LLC
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Dates
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Enumeration Date | 09/17/2013
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 226 COUNTRY CLUB RD
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City | SHALIMAR
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State | FL
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Zip | 32579-2216
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Country | US
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Telephone | 850-240-5866
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Fax | 850-807-5200
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Provider Business Mailing Address
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Address Line | PO BOX 599
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City | SHALIMAR
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State | FL
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Zip | 32579-0599
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Country | US
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Telephone | 850-240-5866
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Fax | 850-807-5200
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Authorized Official
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Title or Position | MGMR
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Name | MRS. AMANDA MARIE WESSON
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Credential | BCBA
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Telephone | 850-240-5866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1-13-14037
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License Number State | FL
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