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General NPI Number Information
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NPI Number | 1679369755
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Entity Type | Organization
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Legal Business Name | EMPOWERING MINDS
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 1001 INDUSTRIAL DR
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City | CRESTVIEW
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State | FL
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Zip | 32539-6943
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Country | US
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Telephone | 850-400-6098
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Fax |
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Provider Business Mailing Address
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Address Line | 124 THOMAS DR SE
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City | LAUREL HILL
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State | FL
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Zip | 32567-3617
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Country | US
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Telephone | 850-896-5946
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Fax |
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Authorized Official
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Title or Position | RBT
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Name | JACOB DYLAN LAMBERT
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Credential |
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Telephone | 850-896-5946
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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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