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NPI Code Detail

MEDICARE: DEJA LANAE NORWOOD MCFADDEN

MEDICARE: DEJA LANAE NORWOOD MCFADDEN
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
1106E00000XAssistant Behavior Analyst0-22-13677GA
2103K00000XBehavior Analyst1-22-60966GA
3106S00000XBehavior Technician

General Provider Information

NPI Number : 1760135065
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEJA LANAE NORWOOD MCFADDEN
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number : 855-832-6727
Fax Number :
Provider Business Practice Location Address
First Line : 500 ALA MOANA BLVD STE 7400
Second Line :
City : HONOLULU
State : HI
Zip : 96813-4902
Country : US
Telephone Number : 855-832-6727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2022
Last Update Date : 01/14/2026

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Directions to “ DEJA LANAE NORWOOD MCFADDEN ” Practice Location

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