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General NPI Number Information
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NPI Number | 1689277030
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Entity Type | Individual
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Provider Name | AUSTEN GLYN ECKHART
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Gender | Female
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 644 FERGUSON DR STE 200
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City | ORLANDO
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State | FL
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Zip | 32805-1023
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Country | US
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Telephone | 407-574-4629
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Fax |
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Provider Business Mailing Address
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Address Line | 760 WALKERS GROVE LN
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City | WINTER GARDEN
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State | FL
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Zip | 34787-2723
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Country | US
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Telephone |
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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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