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General NPI Number Information
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NPI Number | 1679326128
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Entity Type | Individual
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Provider Name | AMBER DANIELLE BUDARY-CORBIN
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Gender | Female
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Dates
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Enumeration Date | 04/05/2024
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Last Update Date | 04/05/2024
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Provider Practice Location Address
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Address Line | 2508 CHATEAU DR
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City | LUTZ
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State | FL
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Zip | 33559-4005
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Country | US
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Telephone | 813-360-3882
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Fax |
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Provider Business Mailing Address
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Address Line | 14521 PRISM CIR
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City | TAMPA
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State | FL
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Zip | 33613-2646
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Country | US
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Telephone | 813-360-3882
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Fax |
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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 | 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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