| Ocean Blue Behavior Therapy Inc | |
|
1137 Bartow Rd Ste 207 Lakeland FL 33801-5828 | |
| (786) 278-8655 | |
| (863) 583-8955 |
| Full Name | Ocean Blue Behavior Therapy Inc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1137 Bartow Rd Ste 207, Lakeland, Florida |
| Authorized Official Name and Position | Maria Eugenia Acosta Dominguez (OWNER) |
| Authorized Official Contact | 7862788655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ocean Blue Behavior Therapy Inc 4515 Ashford Dr Winter Haven FL 33880-1148 Ph: (786) 278-8655 | Ocean Blue Behavior Therapy Inc 1137 Bartow Rd Ste 207 Lakeland FL 33801-5828 Ph: (786) 278-8655 |
| NPI Number | 1114790227 |
|---|---|
| Provider Enumeration Date | 10/31/2023 |
| Last Update Date | 01/23/2025 |
| Certification Date | 01/23/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114790227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Secondary |
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