| Proverbs 22:6 Behavioral Therapy Inc | |
|
1086 Sw Colorado Ave Port St Lucie FL 34953-1803 | |
| (305) 439-0263 | |
| (786) 288-3617 |
| Full Name | Proverbs 22:6 Behavioral Therapy Inc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1086 Sw Colorado Ave, Port St Lucie, Florida |
| Authorized Official Name and Position | Robert James Kidd (PRESIDENT) |
| Authorized Official Contact | 3054390263 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proverbs 22:6 Behavioral Therapy Inc 6365 Collins Ave Apt 4406 Miami Beach FL 33141-9622 Ph: (305) 439-0263 | Proverbs 22:6 Behavioral Therapy Inc 1086 Sw Colorado Ave Port St Lucie FL 34953-1803 Ph: (305) 439-0263 |
| NPI Number | 1649886664 |
|---|---|
| Provider Enumeration Date | 09/16/2020 |
| Last Update Date | 09/16/2020 |
| Certification Date | 09/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649886664 | NPI | - | NPPES |
| 002500900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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