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General NPI Number Information
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NPI Number | 1831609254
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Entity Type | Organization
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Legal Business Name | MOUNTAINEER'S THERAPEUTIC CENTER, INC.
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Dates
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Enumeration Date | 10/11/2017
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Last Update Date | 02/20/2020
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Provider Practice Location Address
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Address Line | 1340 KENWOOD RD
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-7408
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Country | US
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Telephone | 561-932-3938
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Fax |
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Provider Business Mailing Address
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Address Line | 1340 KENWOOD RD
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-7408
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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 | BCBA
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Name | NICOLE HUNNINGS
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Credential |
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Telephone | 910-366-5772
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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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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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