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NPI Code Detail

MEDICARE: DANIELLE PEARSON

MEDICARE: DANIELLE PEARSON
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

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 : 1265974760
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE PEARSON
Provider Business Mailing Address
First Line : 1887 SE PORT ST LUCIE BLVD
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34952-5530
Country : US
Telephone Number : 772-463-0444
Fax Number :
Provider Business Practice Location Address
First Line : 1887 SE PORT ST LUCIE BLVD
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34952-5530
Country : US
Telephone Number : 772-463-0444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2016
Last Update Date : 12/09/2025

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Directions to “ DANIELLE PEARSON ” Practice Location

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