Healthcare Provider Details
I. General information
NPI: 1760399638
Provider Name (Legal Business Name): 1201 THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1201 E 23RD ST
BROOKLYN NY
11210-4520
US
IV. Provider business mailing address
1201 E 23RD ST
BROOKLYN NY
11210-4520
US
V. Phone/Fax
- Phone: 614-780-2019
- Fax:
- Phone: 614-780-2019
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARGILIE
LAHAYAN
Title or Position: MANAGER
Credential:
Phone: 614-780-2019