Judd, Samuel

Judd, Samuel is an individual health care provider with primary practice located at 601 S Lake Destiny Rd Ste 350 , Maitland FL 32751-7222. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Assistant Behavior Analyst, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is his primary health care specialty. Judd, Samuel can be contacted via phone (407) 647-6555.

Contact Information

Primary practice address
601 S Lake Destiny Rd Ste 350 Maitland FL 32751-7222
Phone: (407) 647-6555
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Assistant Behavior Analyst 106E00000X 0-23-14623 Florida
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-24-71059 Florida

Profile Details

NPI number 1679114920
LBN Legal business name Judd, Samuel
Credentials BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2019
Last updated Feb 5th, 2024 - about 9 months 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679114920 NPPES
Other 1-24-71059 BACB
MEDICAID 102795100 BACB

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