MEDICARE: HEALING BEHAVIOR SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1356053516
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING BEHAVIOR SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	19441 SW 212TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33187-4031
Country	:	US
Telephone Number	:	305-216-5690
Fax Number	:

Provider Business Practice Location Address
First Line	:	19441 SW 212TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33187-4031
Country	:	US
Telephone Number	:	305-216-5690
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TRILCE NOVOA
Credential	:
Telephone Number	:	305-216-5690

Provider Enumeration Date	:	12/20/2022
Last Update Date	:	12/20/2022

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