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General NPI Number Information
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NPI Number | 1073264461
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Entity Type | Organization
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Legal Business Name | 3D ABA THERAPY, LLC
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Dates
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Enumeration Date | 01/17/2022
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 2255 GLADES RD STE 324A
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City | BOCA RATON
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State | FL
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Zip | 33431-8571
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Country | US
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Telephone | 786-426-1717
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Fax |
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Provider Business Mailing Address
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Address Line | 2255 GLADES RD STE 324A
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City | BOCA RATON
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State | FL
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Zip | 33431-8571
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Country | US
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Telephone | 786-426-1717
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. LOREYLE CONTRERAS
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Credential |
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Telephone | 786-426-1717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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