Tamara E Land

Individual provider Active NPI Behavior Technician · Callahan, FL

NPI 1508464124 · NPPES record last updated Oct 15, 2020

Key facts

NPI
1508464124
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
617319 W Brandies Ave Apt 1
Callahan, FL 32011-3201
Phone
(904) 654-0701
NPI assigned
Oct 15, 2020
Sex
Female
Sole proprietor
No

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

617319 W Brandies Ave Apt 1
Callahan, FL 32011-3201

Mailing address

PO Box 1983
Callahan, FL 32011-1983
Phone (904) 654-0701

Other providers in Callahan, FL

All providers in Callahan, FL · Behavior Technician in Florida

Sources for this page

Verify at the official NPI Registry.