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Organization
SPACE COAST BEHAVIOR ANALYSIS LLC
Active
Organization
SPACE COAST BEHAVIOR ANALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA SMITH (EXECUTIVE DIRECTOR)
(321) 313-4804
Entity
Organization
Contact information
Practice address
2226 SARNO RD STE 100, MELBOURNE, FL 32935-3087
(321) 313-4804
Mailing address
915 LYTTON RD, MELBOURNE, FL 32934-9015
(321) 313-4804
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/19/2022
Last updated
03/13/2023
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