| Lifelong Behavioral Services, Llc | |
|
4629 Church St Milton FL 32583-4107 | |
| (850) 503-6636 | |
| (850) 626-6132 |
| Full Name | Lifelong Behavioral Services, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4629 Church St, Milton, Florida |
| Authorized Official Name and Position | Marlene Elaine Loewen (BEHAVIOR ANALYST) |
| Authorized Official Contact | 8506266132 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifelong Behavioral Services, Llc 4629 Church St Milton FL 32583-4107 Ph: (850) 503-6636 | Lifelong Behavioral Services, Llc 4629 Church St Milton FL 32583-4107 Ph: (850) 503-6636 |
| NPI Number | 1538679832 |
|---|---|
| Provider Enumeration Date | 10/02/2017 |
| Last Update Date | 09/19/2022 |
| Certification Date | 09/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538679832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-13-13522 (* (Not Available)) | Primary |
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