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General NPI Number Information
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NPI Number | 1750819520
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Entity Type | Individual
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Provider Name | PRISCILLA BAER SCHIMKUS BCBA
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Gender | Female
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Dates
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Enumeration Date | 05/24/2017
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Last Update Date | 02/12/2020
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Provider Practice Location Address
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Address Line | 1051 EBER BLVD STE 108
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City | MELBOURNE
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State | FL
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Zip | 32904-8768
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Country | US
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Telephone | 321-536-3532
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Fax |
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Provider Business Mailing Address
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Address Line | 24 E AVENUE C
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City | MELBOURNE
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State | FL
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Zip | 32901-1334
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Country | US
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Telephone | 321-427-3191
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-16-7511
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-20-40532
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License Number State |
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