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NPI Code Detail

MEDICARE: REBECCA MARIE BOUDREAU

MEDICARE: REBECCA MARIE BOUDREAU
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
1103K00000XBehavior Analyst1-22-58068FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144886581
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA MARIE BOUDREAU
Provider Business Mailing Address
First Line : 26844 TANIC DR
Second Line :
City : WESLEY CHAPEL
State : FL
Zip : 33544-4616
Country : US
Telephone Number : 813-710-3014
Fax Number : 813-710-3014
Provider Business Practice Location Address
First Line : 26844 TANIC DR
Second Line :
City : WESLEY CHAPEL
State : FL
Zip : 33544-4616
Country : US
Telephone Number : 813-710-3014
Fax Number : 813-710-3014
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2019
Last Update Date : 05/27/2026

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Directions to “ REBECCA MARIE BOUDREAU ” Practice Location

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