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General NPI Number Information
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NPI Number | 1508267980
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL PROGRESSION, INC
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Dates
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Enumeration Date | 09/04/2014
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Last Update Date | 10/15/2018
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Provider Practice Location Address
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Address Line | 1284 DEVIN OAKS CT
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City | LAKELAND
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State | FL
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Zip | 33811-2383
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Country | US
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Telephone | 863-602-0698
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Fax | 813-354-2715
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Provider Business Mailing Address
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Address Line | 1284 DEVIN OAKS CT
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City | LAKELAND
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State | FL
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Zip | 33811-2383
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Country | US
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Telephone | 863-602-0698
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Fax | 813-354-2715
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Authorized Official
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Title or Position | OWNER
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Name | MRS. NICOLE MINARD
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Credential | M.A., BCBA
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Telephone | 863-602-0698
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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 | 1-14-15928
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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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