Individual
MRS. BRIDGET CONQUEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4647 CLYDE MORRIS BLVD, PORT ORANGE, FL 32129-3000
(386) 767-3752
Mailing address
356 WESTERN RD, NEW SMYRNA BEACH, FL 32168-8969
(908) 965-5220
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-76645
FL
106E00000X
Assistant Behavior Analyst
0-24-15068
FL
106S00000X
Behavior Technician
—
FL
222Q00000X
Developmental Therapist
—
FL
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
02/10/2020
Last updated
10/18/2024
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