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General NPI Number Information
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NPI Number | 1720791643
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Entity Type | Individual
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Provider Name | JULIANNE STANNERS
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Gender | Female
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Dates
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Enumeration Date | 01/05/2023
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 560 VILLAGE BLVD STE 100
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-1963
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Country | US
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Telephone | 772-773-1437
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Fax |
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Provider Business Mailing Address
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Address Line | 3409 VICTOR AVE
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City | BROOKHAVEN
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State | PA
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Zip | 19015-2725
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Country | US
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Telephone | 610-762-8663
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BH005578
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License Number State | PA
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