Source Route Products, LLC

NPI #1639423247 in Hernando, Florida

Provider Information

NPI Number: 1639423247
Entity Type: Organization
Organization Name: Source Route Products, LLC
Primary Specialty: Behavior Analyst
Enumeration Date: Nov 5, 2012
Last Updated: Nov 5, 2012

Practice Location

Address: 3795 E PARSONS POINT RD
Address 2: BOX 1047
City: Hernando
State: Florida
ZIP Code: 34442-7701
Phone: (202) 480-9234

Authorized Official

Name: DR. KIMBERLY MILLS, PH.D, BCBA
Title: MEMBER
Phone: (202) 480-9234

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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