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General NPI Number Information
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NPI Number | 1831637552
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Entity Type | Organization
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Legal Business Name | O'CONNELL BEHAVIORAL SERVICES
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Dates
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Enumeration Date | 02/01/2017
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Last Update Date | 02/01/2017
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Provider Practice Location Address
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Address Line | 3788 HUDSON CT
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City | NAPLES
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State | FL
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Zip | 34116-7325
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Country | US
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Telephone | 239-784-4989
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Fax |
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Provider Business Mailing Address
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Address Line | 3788 HUDSON CT
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City | NAPLES
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State | FL
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Zip | 34116-7325
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Country | US
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Telephone | 239-784-4989
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Fax |
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Authorized Official
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Title or Position | BEHAVIOR ANALYST
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Name | CAROLYN D O'CONNELL
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Credential | M.S, BCBA
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Telephone | 239-784-4989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1-11-7957
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License Number State | FL
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