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General NPI Number Information
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NPI Number | 1558068593
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Entity Type | Individual
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Provider Name | TIMALI DEWMI NISAK WIJESINGHE
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Gender | Female
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Dates
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Enumeration Date | 02/09/2023
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 9405 BARNSTEAD LN
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City | PORT RICHEY
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State | FL
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Zip | 34668-4302
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Country | US
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Telephone | 727-967-2809
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Fax | 858-952-0502
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Provider Business Mailing Address
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Address Line | 350 FAIRWAY DR STE 101
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-1834
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Country | US
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Telephone | 877-418-2978
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Fax | 866-500-2186
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1-24-78129
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License Number State | FL
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