Healthcare Provider Details
I. General information
NPI: 1205354065
Provider Name (Legal Business Name): UNFOLDING BRIGHT MINDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/31/2017
Last Update Date: 08/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10181 NW 58TH ST UNIT 14
DORAL FL
33178-2705
US
IV. Provider business mailing address
1504 BAY RD APT 1215
MIAMI BEACH FL
33139-3273
US
V. Phone/Fax
- Phone: 786-712-6494
- Fax:
- Phone: 786-712-6494
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ASHLEY
DIANNE
CURCIO
Title or Position: OWNER/DIRECTOR
Credential: M.ED., BCBA
Phone: 786-712-6494