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General NPI Number Information
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NPI Number | 1477162345
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Entity Type | Organization
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Legal Business Name | TUKKOS THERAPY CENTER INC
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 1425 VISCAYA PKWY STE 204
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City | CAPE CORAL
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State | FL
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Zip | 33990-3294
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Country | US
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Telephone | 239-351-1445
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Fax | 239-201-3894
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Provider Business Mailing Address
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Address Line | 240 W PALMETTO PARK RD STE 310
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City | BOCA RATON
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State | FL
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Zip | 33432-3761
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Country | US
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Telephone | 786-277-7842
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE GONZALES
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Credential |
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Telephone | 786-277-7842
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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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