Amber Lively
Individual provider Active NPI Behavior Technician · Mascotte, FL
NPI 1073239455 · NPPES record last updated Oct 31, 2022
Key facts
- NPI
- 1073239455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 3915 W Cardinal Pine Dr
Mascotte, FL 34753-8861 - Phone
- (352) 636-8653
- NPI assigned
- Oct 17, 2022
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | FL | Yes |
Addresses
Primary practice location
3915 W Cardinal Pine Dr
Mascotte, FL 34753-8861
Mailing address
3915 W Cardinal Pine Dr
Mascotte, FL 34753-8861
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | sshawk11@aol.com |
Other providers in Mascotte, FL
- Humble Healings, LLC
- Jonesha Lafong
- Life Change Outreach Organization
- Life Change Outreach Organization, Inc
- Life Change Outreach Organization, Inc
- Lowell F Clark MD PA
- Alicia Ann Meeks
- Antonio Norat Jr.
- Justo Nual Perez
- Tyler Peeler
All providers in Mascotte, 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 Oct 31, 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.