Healthcare Provider Details

I. General information

NPI: 1750976221
Provider Name (Legal Business Name): SPECIAL WAY ABA, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2021
Last Update Date: 04/13/2022
Certification Date: 04/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34240 SW 187TH AVE UNIT 104
FLORIDA CITY FL
33034-2026
US

IV. Provider business mailing address

34240 SW 187TH AVE UNIT 104
FLORIDA CITY FL
33034-2026
US

V. Phone/Fax

Practice location:
  • Phone: 786-612-9793
  • Fax:
Mailing address:
  • Phone: 786-612-9793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MRS. YAMILET GIRON
Title or Position: PRESIDENT
Credential:
Phone: 786-612-9793