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NPI Code Detail

MEDICARE: MRS. EILEEN M HEGARTY BCABA

MEDICARE: MRS. EILEEN M HEGARTY BCABA
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
1103K00000XBehavior Analyst0135433FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740622000
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EILEEN M HEGARTY BCABA
Provider Business Mailing Address
First Line : 47 TAHITI RD
Second Line :
City : MARCO ISLAND
State : FL
Zip : 34145-4034
Country : US
Telephone Number : 617-957-6353
Fax Number :
Provider Business Practice Location Address
First Line : 6714 WINKLER RD
Second Line :
City : FORT MYERS
State : FL
Zip : 33919-7204
Country : US
Telephone Number : 239-245-8301
Fax Number : 239-245-8731
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2013
Last Update Date : 07/26/2013

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