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NPI Code Detail

MEDICARE: EMPOWERING MINDS

MEDICARE: EMPOWERING MINDS
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

General Provider Information

NPI Number : 1679369755
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMPOWERING MINDS
Provider Business Mailing Address
First Line : 124 THOMAS DR SE
Second Line :
City : LAUREL HILL
State : FL
Zip : 32567-3617
Country : US
Telephone Number : 850-896-5946
Fax Number :
Provider Business Practice Location Address
First Line : 1001 INDUSTRIAL DR
Second Line :
City : CRESTVIEW
State : FL
Zip : 32539-6943
Country : US
Telephone Number : 850-400-6098
Fax Number :
Authorized Official
Title or Position : RBT
Name : JACOB DYLAN LAMBERT
Credential :
Telephone Number : 850-896-5946
Provider Enumeration Date : 04/16/2025
Last Update Date : 04/16/2025

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Directions to “EMPOWERING MINDS ” Practice Location

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