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General NPI Number Information
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NPI Number | 1538371257
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Entity Type | Organization
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Legal Business Name | DEVELOPMENTAL INTERVENTION SPECIALISTS INC
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13101 MAHOGANY BAY DR.
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City | BOYNTON BEACH
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State | FL
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Zip | 33436
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Country | US
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Telephone | 561-543-0417
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Fax | 561-733-8779
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Provider Business Mailing Address
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Address Line | 1779 N CONGRESS AVE #336
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8205
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Country | US
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Telephone | 561-543-0417
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Fax | 561-733-8779
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Authorized Official
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Title or Position | PRESIDENT CERTIFIED BEHAVIOR ANALYS
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Name | MRS. BELKIS COUPET I
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Credential | M.S.
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Telephone | 561-543-0417
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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 | 1020949
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License Number State | FL
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