MEDICARE: MS. STEPHANIE LUCILLE TARGONSKI

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
2	2355S0801X	Speech-Language Assistant	SI8467	FL

General Provider Information

NPI Number	:	1588425441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STEPHANIE LUCILLE TARGONSKI

Provider Business Mailing Address
First Line	:	224 SE SAINT LUCIE BLVD APT 206
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34996-1387
Country	:	US
Telephone Number	:	203-604-4682
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 S MILITARY TRL STE D
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-4698
Country	:	US
Telephone Number	:	561-328-8312
Fax Number	:

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

Provider Enumeration Date	:	01/18/2024
Last Update Date	:	05/29/2026

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Directions to “ MS. STEPHANIE LUCILLE TARGONSKI ” Practice Location

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