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General NPI Number Information
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NPI Number | 1679301204
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Entity Type | Organization
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Legal Business Name | SANTAMORE NICOLE LLC
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Dates
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Enumeration Date | 07/24/2024
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 2226 SARNO RD STE 100
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City | MELBOURNE
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State | FL
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Zip | 32935-3087
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Country | US
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Telephone | 321-408-6393
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Fax |
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Provider Business Mailing Address
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Address Line | 3061 DAGGET AVE SE
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City | PALM BAY
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State | FL
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Zip | 32909-8113
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Country | US
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Telephone | 207-206-2743
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. NICOLE SANTAMORE
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Credential | BCBA
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Telephone | 321-408-6393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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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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