Provider Demographics
NPI:1366878258
Name:HIMEL, EILEEN SIMON (BA)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:SIMON
Last Name:HIMEL
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 MARION WAY
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31098-1178
Mailing Address - Country:US
Mailing Address - Phone:225-206-1320
Mailing Address - Fax:
Practice Address - Street 1:4301 N FEDERAL HIGHWAY
Practice Address - Street 2:BUTTERFLY EFFECTS LLC
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064
Practice Address - Country:US
Practice Address - Phone:888-880-9270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist