Carly Malin
Individual provider Active NPI Behavior Technician · Fort White, FL
NPI 1598545865 · NPPES record last updated Oct 3, 2023
Key facts
- NPI
- 1598545865
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 624 SW Central Ter
Fort White, FL 32038-7916 - Phone
- (954) 684-4209
- NPI assigned
- Oct 3, 2023
- 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 | Yes |
Addresses
Primary practice location
624 SW Central Ter
Fort White, FL 32038-7916
Mailing address
624 SW Central Ter
Fort White, FL 32038-7916
Other providers in Fort White, FL
- Ja'Chari Johnson
- Susan Virginia Koontz
- Jessica Land
- Marion M Landua-Figueroa
- Jose Luis Lopez
- Maria'S Support Coordination LLC
- Dianne Marroletti
- Kathleen Marshall
- Kaleah McCoy
- Maylenis Melian
All providers in Fort White, 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 3, 2023. 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.