Healthcare Provider Details
I. General information
NPI: 1306300538
Provider Name (Legal Business Name): AYE COUNSELOR & BEHAVIOR THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/22/2019
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8100 NW 155TH ST STE 200
MIAMI LAKES FL
33016-5865
US
IV. Provider business mailing address
8100 NW 155TH ST STE 200
MIAMI LAKES FL
33016-5865
US
V. Phone/Fax
- Phone: 786-241-1761
- Fax: 786-542-5084
- Phone: 786-241-1761
- Fax: 786-542-5084
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 | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YAMILE
MUNOZ PANG
Title or Position: PRESIDENT
Credential:
Phone: 786-241-1761