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General NPI Number Information
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NPI Number | 1992133698
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Entity Type | Organization
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Legal Business Name | DEVELOPMENTAL INTERVENTION SPECIALISTS
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 10/16/2013
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Provider Practice Location Address
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Address Line | 1779 N CONGRESS AVE # 336
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8205
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Country | US
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Telephone | 800-686-5614
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Fax | 561-736-5800
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Provider Business Mailing Address
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Address Line | 1779 N CONGRESS AVE # 336
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8205
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Country | US
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Telephone | 800-686-5614
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Fax | 561-736-5800
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Authorized Official
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Title or Position | BEHAVIOR THERAPIST
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Name | GRACIELE GADAMS
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Credential | B.A
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Telephone | 800-686-5614
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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 |
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License Number State |
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