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NPI Code Detail

MEDICARE: AMANDA B DENHAM BEHAVIOR TECHNCIAN

MEDICARE: AMANDA B DENHAM BEHAVIOR TECHNCIAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1124712500
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA B DENHAM BEHAVIOR TECHNCIAN
Provider Business Mailing Address
First Line : 1500 S DOUGLAS RD STE 230
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4108
Country : US
Telephone Number : 844-244-1818
Fax Number :
Provider Business Practice Location Address
First Line : 177 MOUSE CREEK RD NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-3838
Country : US
Telephone Number : 423-244-1186
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2023
Last Update Date : 06/12/2024

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Directions to “ AMANDA B DENHAM BEHAVIOR TECHNCIAN” Practice Location

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