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General NPI Number Information
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NPI Number | 1285876540
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Entity Type | Organization
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Legal Business Name | BEYOND EXPECTATIONS
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 04/01/2009
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Provider Practice Location Address
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Address Line | 21 LONGWOOD DR
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City | SHALIMAR
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State | FL
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Zip | 32579-1013
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Country | US
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Telephone | 251-605-1017
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Fax |
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Provider Business Mailing Address
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Address Line | 21 LONGWOOD DR
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City | SHALIMAR
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State | FL
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Zip | 32579-1013
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Country | US
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Telephone | 251-605-1017
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Fax |
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Authorized Official
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Title or Position | EXEC. DIRECTOR
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Name | KAREN REID
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Credential |
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Telephone | 251-605-1017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | FL
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Taxonomy #2
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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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