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General NPI Number Information
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NPI Number | 1760627905
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Entity Type | Organization
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Legal Business Name | APPLIED BEHAVIORAL LEARNING EXPERIENCES, INC
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Dates
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Enumeration Date | 12/02/2008
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 454 W PIPKIN RD
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City | LAKELAND
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State | FL
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Zip | 33813-2545
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Country | US
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Telephone | 863-619-2809
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Fax | 863-646-9590
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Provider Business Mailing Address
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Address Line | PO BOX 2112
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City | LAKELAND
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State | FL
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Zip | 33806-2112
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Country | US
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Telephone | 863-581-1583
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Fax | 863-644-9590
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Authorized Official
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Title or Position | BEHAVIOR ANALYST
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Name | MRS. STACEY LYN OSMON
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Credential | M.S. ED, BCBA
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Telephone | 863-581-1583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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