Eamon Anderson
Individual provider Active NPI Behavior Technician · Niceville, FL
NPI 1649802471 · NPPES record last updated Feb 10, 2020
Key facts
- NPI
- 1649802471
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 4673 E Highway 20
Niceville, FL 32578-9796 - Phone
- (850) 607-6910
- Fax
- (850) 607-6932
- NPI assigned
- Feb 10, 2020
- Sex
- Male
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | FL | Yes |
Addresses
Primary practice location
4673 E Highway 20
Niceville, FL 32578-9796
Mailing address
3771 Stefani Rd
Cantonment, FL 32533-7795
Phone (850) 607-6910
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2020. 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.