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General NPI Number Information
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NPI Number | 1730784406
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Entity Type | Organization
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Legal Business Name | AVID INTELLECTUAL INC.
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 6280 HAMILTON DR LOT 35
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City | FORT MYERS
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State | FL
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Zip | 33905-4428
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Country | US
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Telephone | 786-505-4543
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Fax |
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Provider Business Mailing Address
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Address Line | 6280 HAMILTON DR LOT 35
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City | FORT MYERS
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State | FL
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Zip | 33905-4428
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Country | US
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Telephone | 786-505-4543
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CANDACE DRUMMOND
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Credential | LMHC, BCBA
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Telephone | 786-505-4543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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