MEDICARE: MR. TIMOTHY ALTHOUSE

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
1	106S00000X	Behavior Technician		FL

General Provider Information

NPI Number	:	1437007465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TIMOTHY ALTHOUSE

Provider Business Mailing Address
First Line	:	2050 OLEANDER BLVD APT 5-203
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34950-5394
Country	:	US
Telephone Number	:	561-310-4042
Fax Number	:

Provider Business Practice Location Address
First Line	:	2050 OLEANDER BLVD APT 5-203
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34950-5394
Country	:	US
Telephone Number	:	561-310-4042
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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Directions to “ MR. TIMOTHY ALTHOUSE ” Practice Location

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