| Cardinal Aba Services, Llc | |
|
139 Beal Pkwy Se Unit 107 Fort Walton Beach FL 32548-5343 | |
| (850) 803-2562 | |
| Not Available |
| Full Name | Cardinal Aba Services, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 139 Beal Pkwy Se Unit 107, Fort Walton Beach, Florida |
| Authorized Official Name and Position | Rachele Elizabeth Sage (OWNER) |
| Authorized Official Contact | 8508032562 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cardinal Aba Services, Llc 115 Knollwood Way Fort Walton Beach FL 32548-6335 Ph: (850) 803-2562 | Cardinal Aba Services, Llc 139 Beal Pkwy Se Unit 107 Fort Walton Beach FL 32548-5343 Ph: (850) 803-2562 |
| NPI Number | 1730758277 |
|---|---|
| Provider Enumeration Date | 06/19/2021 |
| Last Update Date | 08/24/2021 |
| Certification Date | 08/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730758277 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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