Healthcare Provider Details

I. General information

NPI: 1427763689
Provider Name (Legal Business Name): INFINITE BEHAVIOR THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2023
Last Update Date: 02/20/2023
Certification Date: 02/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12800 SW 20TH ST
MIRAMAR FL
33027-2517
US

IV. Provider business mailing address

12800 SW 20TH ST
MIRAMAR FL
33027-2517
US

V. Phone/Fax

Practice location:
  • Phone: 954-682-7038
  • Fax:
Mailing address:
  • Phone: 954-682-7038
  • 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
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KAREN PARKIN
Title or Position: CLINICAL DIRECTOR
Credential: BCBA
Phone: 954-682-7038