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General NPI Number Information
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NPI Number | 1609189778
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Entity Type | Organization
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Legal Business Name | FLORIDA BEHAVIORAL SERVICES FOR CHILDREN
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 5718 SEA TROUT PL
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City | APOLLO BEACH
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State | FL
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Zip | 33572-3348
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Country | US
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Telephone | 617-852-7899
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Fax |
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Provider Business Mailing Address
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Address Line | 5718 SEA TROUT PL
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City | APOLLO BEACH
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State | FL
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Zip | 33572-3348
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Country | US
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Telephone | 617-852-7899
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JANIS LYNN KREMPA
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Credential | M.ED, BCBA
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Telephone | 617-852-7899
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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 | 1-03-1336
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License Number State | FL
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