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General NPI Number Information
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NPI Number | 1134992662
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Entity Type | Organization
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Legal Business Name | GG BEHAVIOR THERAPY LLC
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Dates
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Enumeration Date | 11/06/2023
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 2210 NW 92ND AVE
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City | DORAL
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State | FL
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Zip | 33172-4813
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Country | US
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Telephone | 786-366-9526
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Fax |
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Provider Business Mailing Address
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Address Line | 6501 SW 139TH CT APT 305
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City | MIAMI
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State | FL
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Zip | 33183-2088
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Country | US
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Telephone | 786-366-9526
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GLENDA ORIA GONZALEZ
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Credential | BCBA
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Telephone | 786-366-9526
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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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