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NPI Code Detail

MEDICARE: MRS. ADELLE SUTTON

MEDICARE: MRS. ADELLE SUTTON
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 TechnicianRBT-18-67742FL
2103K00000XBehavior Analyst1-19-37928FL

General Provider Information

NPI Number : 1457827495
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ADELLE SUTTON
Provider Business Mailing Address
First Line : 3771 STEFANI RD
Second Line :
City : CANTONMENT
State : FL
Zip : 32533-7795
Country : US
Telephone Number : 850-607-6910
Fax Number :
Provider Business Practice Location Address
First Line : 1981 LEWIS TURNER BLVD
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32547-1256
Country : US
Telephone Number : 850-607-6910
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2018
Last Update Date : 01/07/2020

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Directions to “ MRS. ADELLE SUTTON ” Practice Location

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