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General NPI Number Information
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NPI Number | 1306619648
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Entity Type | Organization
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Legal Business Name | JRJ BEHAVIORTHERAPY II CORP
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 11372 SW 234TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33032-6273
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Country | US
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Telephone | 786-468-5129
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Fax |
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Provider Business Mailing Address
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Address Line | 11372 SW 234TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33032-6273
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGISTERED BEHAVIOR TECHNICIAN
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Name | RUDY VALDES
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Credential |
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Telephone | 786-468-5129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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