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General NPI Number Information
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NPI Number | 1245992676
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Entity Type | Organization
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Legal Business Name | MINDFUL MUSICAL MINDS BEHAVIOR SOLUTIONS
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Dates
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Enumeration Date | 10/13/2021
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 11100 BONITA BEACH RD SE STE 107
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-5701
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Country | US
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Telephone | 239-703-3092
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Fax |
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Provider Business Mailing Address
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Address Line | 11100 BONITA BEACH RD SE STE 107
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-5701
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Country | US
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Telephone | 239-703-3092
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARCELA GUIMOYE
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Credential | BCBA
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Telephone | 239-703-3092
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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 | Behavioral Analyst
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License Number |
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License Number State |
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