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General NPI Number Information
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NPI Number | 1336688670
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Entity Type | Organization
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Legal Business Name | DIAMOND BEHAVIORAL SERVICES
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 02/23/2017
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Provider Practice Location Address
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Address Line | 460 7TH PLACE
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City | VERO BEACH
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State | FL
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Zip | 32962
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Country | US
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Telephone | 772-205-0937
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Fax | 772-925-7927
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Provider Business Mailing Address
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Address Line | 460 7TH PLACE
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City | VERO BEACH
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State | FL
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Zip | 32962-7000
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Country | US
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Telephone | 772-205-0937
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Fax | 772-925-7927
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Authorized Official
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Title or Position | PRESIDENT
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Name | REBECCA INMAN
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Credential |
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Telephone | 772-205-0937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-16-12178
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License Number State | FL
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