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General NPI Number Information
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NPI Number | 1992132484
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Entity Type | Organization
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Legal Business Name | ALEMBIA, INC.
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Dates
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Enumeration Date | 09/30/2013
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Last Update Date | 09/30/2013
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Provider Practice Location Address
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Address Line | 8359 BEACON BLVD STE 411
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City | FORT MYERS
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State | FL
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Zip | 33907-3065
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Country | US
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Telephone | 239-425-2616
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Fax | 239-236-1718
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Provider Business Mailing Address
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Address Line | 1417 SE 24TH AVE APT C
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City | CAPE CORAL
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State | FL
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Zip | 33990-1974
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Country | US
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Telephone | 239-784-3741
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Fax | 239-236-1718
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. BRENDA JEANNE BAKER
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Credential | MA, BCBA, LMT
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Telephone | 239-784-3741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA 57488
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License Number State | FL
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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 | BCBA 1-09-5040
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License Number State | FL
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