Holly Bowers
Individual provider Active NPI Behavior Technician · Palm City, FL
NPI 1033719455 · NPPES record last updated Dec 30, 2022
Key facts
- NPI
- 1033719455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-20-142152 (FL)
- Practice address
- 1532 SW Mapp Rd
Palm City, FL 34990-2446 - Phone
- (772) 214-9001
- NPI assigned
- Oct 26, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-142152 | FL | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-20-142152 | FL | Yes |
Addresses
Primary practice location
1532 SW Mapp Rd
Palm City, FL 34990-2446
Mailing address
1532 SW Mapp Rd
Palm City, FL 34990-2446
Phone (772) 214-9001
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108643700 | Medicaid | FL |
NPI Registry JSON
{
"created_epoch": "1603670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672358400000",
"number": "1033719455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1532 SW MAPP RD",
"city": "PALM CITY",
"state": "FL",
"postal_code": "349902446",
"telephone_number": "772-214-9001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1532 SW MAPP RD",
"city": "PALM CITY",
"state": "FL",
"postal_code": "349902446",
"telephone_number": "772-214-9001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWERS",
"first_name": "HOLLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-26",
"last_updated": "2022-12-30",
"certification_date": "2022-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-20-142152",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "108643700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm City, FL
- Danela Del Pilar Boucourt
- Mary Beth Boudrias
- Sydnie Kristine Bournival
- Mason Bowden
- Jae-an Bowen
- Kristen Denise Bowman
- Heaven Noelle Bradbury
- Miranda Bradley
- Amanda Bramlett
- Kylee A Brazelton
All providers in Palm City, FL · Behavior Technician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.