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General NPI Number Information
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NPI Number | 1851004030
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Entity Type | Organization
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Legal Business Name | PREMIER BEHAVIORAL HEALTH CONSULTING
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Dates
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Enumeration Date | 01/03/2023
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Last Update Date | 01/03/2023
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Provider Practice Location Address
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Address Line | 92295 OLD STATE ROAD
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City | ISLAMORADA
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State | FL
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Zip | 33070
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Country | US
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Telephone | 786-975-4609
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Fax |
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Provider Business Mailing Address
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Address Line | 4249 MOUNT BANDON DR
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City | LAND O LAKES
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State | FL
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Zip | 34638-3685
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Country | US
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Telephone | 813-702-0435
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Fax |
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Authorized Official
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Title or Position | FOUNDER & CEO
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Name | DR. DIDIANA DE LA OSA
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Credential | DBH, BCBA-D
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Telephone | 813-702-0435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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