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NPI Code Detail

MEDICARE: DANIELLE EDWARDS

MEDICARE: DANIELLE EDWARDS
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
2103K00000XBehavior Analyst

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 : 1265946214
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE EDWARDS
Provider Business Mailing Address
First Line : 40347 US HIGHWAY 19 N STE 103
Second Line :
City : TARPON SPRINGS
State : FL
Zip : 34689-4841
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 40347 US HIGHWAY 19 N STE 103
Second Line :
City : TARPON SPRINGS
State : FL
Zip : 34689-4841
Country : US
Telephone Number : 434-228-1382
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2017
Last Update Date : 03/03/2020

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Directions to “ DANIELLE EDWARDS ” Practice Location

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