Provider Demographics
NPI:1922434448
Name:AIMEE STEPHENS BCBA INC.
Entity Type:Organization
Organization Name:AIMEE STEPHENS BCBA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:AIMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:321-432-4661
Mailing Address - Street 1:PO BOX 2462
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32902-2462
Mailing Address - Country:US
Mailing Address - Phone:321-432-4661
Mailing Address - Fax:
Practice Address - Street 1:520 LATANIA PALM DR
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903-3816
Practice Address - Country:US
Practice Address - Phone:321-432-4661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-10-7790251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health