| Lifesprout, Llc | |
|
1115 Golden Lakes Blvd Apt 524 West Palm Beach FL 33411-3331 | |
| (561) 596-8791 | |
| (561) 471-1332 |
| Full Name | Lifesprout, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1115 Golden Lakes Blvd Apt 524, West Palm Beach, Florida |
| Authorized Official Name and Position | Rocco L. Nocera (MANAGING MEMBER) |
| Authorized Official Contact | 5615968791 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifesprout, Llc 1115 Golden Lakes Blvd Apt 524 West Palm Beach FL 33411-3331 Ph: (561) 596-8791 | Lifesprout, Llc 1115 Golden Lakes Blvd Apt 524 West Palm Beach FL 33411-3331 Ph: (561) 596-8791 |
| NPI Number | 1952549982 |
|---|---|
| Provider Enumeration Date | 01/29/2009 |
| Last Update Date | 01/29/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952549982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-07-3256 (Florida) | Primary |
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