Healthcare Provider Details
I. General information
NPI: 1154771475
Provider Name (Legal Business Name): CINDY MEJIA M.ED., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/17/2016
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7236 S CENTRAL AVE
PHOENIX AZ
85042-5425
US
IV. Provider business mailing address
1211 N 74TH WAY
HOLLYWOOD FL
33024-5314
US
V. Phone/Fax
- Phone: 885-772-8847
- Fax: 248-479-4431
- Phone: 305-742-6740
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 222Q00000X |
| Taxonomy | Developmental Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: