Christopher William Blydenburgh

Individual provider Active NPI Behavior Technician · Hernando, FL

NPI 1306483409 · NPPES record last updated Dec 8, 2019

Key facts

NPI
1306483409
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
2535 E Marco CT # 11
Hernando, FL 34442-2962
Phone
(352) 270-5003
NPI assigned
Dec 8, 2019
Sex
Male
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)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

2535 E Marco CT # 11
Hernando, FL 34442-2962

Mailing address

2535 E Marco CT # 11
Hernando, FL 34442-2962
Phone (352) 270-5003

Other providers in Hernando, FL

All providers in Hernando, FL · Behavior Technician in Florida

Sources for this page

Verify at the official NPI Registry.