| Easterseals Northeast Central Florida, Inc. | |
|
3804 Pioneer Trl New Smyrna Beach FL 32168-8784 | |
| (386) 255-4568 | |
| (386) 258-7677 |
| Full Name | Easterseals Northeast Central Florida, Inc. |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3804 Pioneer Trl, New Smyrna Beach, Florida |
| Authorized Official Name and Position | Michele Wallens (ACCOUNTING MANAGER) |
| Authorized Official Contact | 3862554568 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easterseals Northeast Central Florida, Inc. 1219 Dunn Ave Daytona Beach FL 32114-2405 Ph: (386) 255-4568 | Easterseals Northeast Central Florida, Inc. 3804 Pioneer Trl New Smyrna Beach FL 32168-8784 Ph: (386) 255-4568 |
| NPI Number | 1780435958 |
|---|---|
| Provider Enumeration Date | 03/27/2024 |
| Last Update Date | 03/27/2024 |
| Certification Date | 02/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780435958 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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