MEDICARE: COMPREHENSIVE BEHAVIOR SERVICES

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1619659489
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE BEHAVIOR SERVICES

Provider Business Mailing Address
First Line	:	5570 SPANISH MOSS CV
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34203-2114
Country	:	US
Telephone Number	:	586-913-5024
Fax Number	:

Provider Business Practice Location Address
First Line	:	5570 SPANISH MOSS CV
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34203-2114
Country	:	US
Telephone Number	:	586-913-5024
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	JACQUELYN MARQUES
Credential	:	BCBA
Telephone Number	:	586-913-5024

Provider Enumeration Date	:	08/02/2023
Last Update Date	:	08/02/2023

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Directions to “COMPREHENSIVE BEHAVIOR SERVICES ” Practice Location

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