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NPI 1487514352

NPI 1487514352 : DEMURE BEHAVIOR THERAPY, LLC : PORT SAINT LUCIE, FL

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General NPI Number Information
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    NPI Number           |    1487514352
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    Entity Type          |    Organization 
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    Legal Business Name  |    DEMURE BEHAVIOR THERAPY, LLC 
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Dates
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    Enumeration Date     |    11/13/2025
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    Last Update Date     |    11/13/2025
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Provider Practice Location Address
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    Address Line         |    681 NW STANFORD LN 
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    City                 |    PORT SAINT LUCIE
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    State                |    FL
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    Zip                  |    34983-3406
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    Country              |    US
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    Telephone            |    561-240-9185
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    681 NW STANFORD LN 
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    City                 |    PORT SAINT LUCIE
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    State                |    FL
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    Zip                  |    34983-3406
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    Country              |    US
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    Telephone            |    561-240-9185
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     JASMINE R PAIGE 
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    Credential           |    
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    Telephone            |    561-240-9185
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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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