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General NPI Number Information
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NPI Number | 1386153617
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Entity Type | Organization
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Legal Business Name | CREATIVE BEHAVIOR THERAPY, INC
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Dates
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Enumeration Date | 09/29/2017
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Last Update Date | 09/29/2017
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Provider Practice Location Address
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Address Line | 5249 NW 7TH ST APT 413
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City | MIAMI
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State | FL
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Zip | 33126-3378
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Country | US
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Telephone | 786-337-1451
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Fax |
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Provider Business Mailing Address
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Address Line | 5249 NW 7TH ST APT 413
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City | MIAMI
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State | FL
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Zip | 33126-3378
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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 | PRESIDENT
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Name | JULIET MARIAM ARAUJO
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Credential | LCSW
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Telephone | 786-337-1451
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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 | SW9757
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License Number State | FL
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