Habyan, Kelly
Habyan, Kelly is an sole proprietor health care provider with primary practice located at 2100 Se Hillmoor Dr Ste 104 , Port St Lucie FL 34952-8057. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist is her primary health care specialty. Habyan, Kelly can be contacted via phone (772) 380-9972.Contact Information
Primary practice address
2100 Se Hillmoor Dr Ste 104
Port St Lucie FL 34952-8057
Phone: (772) 380-9972
Fax: (772) 380-9976
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | ||
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist | 222Q00000X |
Profile Details
| NPI number | 1326165432 |
|---|---|
| LBN Legal business name | Habyan, Kelly |
| Credentials | Bachelor of Arts (BA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 23rd, 2007 |
| Last updated | Dec 21st, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326165432 | NPPES |
| Florida | MEDICAID | 113781100 | |
| Florida | MEDICAID | 768088100 | |
| Florida | MEDICAID | 811866300 |
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