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General NPI Number Information
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NPI Number | 1366683310
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC BEHAVIORAL ASSESSMENT
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Dates
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Enumeration Date | 03/19/2009
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 8200 SW 117TH AVE SUITE 306
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City | MIAMI
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State | FL
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Zip | 33183-3856
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Country | US
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Telephone | 305-274-0640
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Fax | 305-274-0630
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Provider Business Mailing Address
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Address Line | 8200 SW 117TH AVE SUITE 306
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City | MIAMI
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State | FL
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Zip | 33183-3856
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Country | US
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Telephone | 305-274-0640
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Fax | 305-274-0630
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. HARRY DAMUS
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Credential | PSY.D.
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Telephone | 305-274-0640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PY 7870
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License Number State | FL
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