Healthcare Provider Details

I. General information

NPI: 1073232831
Provider Name (Legal Business Name): KIDS MAGICAL ABA WORLD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9750 JAMAICA DR
CUTLER BAY FL
33189-1753
US

IV. Provider business mailing address

9750 JAMAICA DR
CUTLER BAY FL
33189-1753
US

V. Phone/Fax

Practice location:
  • Phone: 305-781-0988
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: NATHALY WICHMAN
Title or Position: OWNER
Credential:
Phone: 305-781-0988