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General NPI Number Information
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NPI Number | 1568911683
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL STRIDES THERAPY
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Dates
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Enumeration Date | 09/30/2016
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 5850 ATLANTIC AVE STE 112
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8427
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Country | US
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Telephone | 561-336-0358
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Fax |
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Provider Business Mailing Address
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Address Line | 5850 ATLANTIC AVE STE 112
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8427
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Country | US
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Telephone | 561-336-0358
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Fax |
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Authorized Official
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Title or Position | CO-PRESIDENT
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Name | JULIE DIAGO
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Credential | BCBA
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Telephone | 561-336-0358
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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 | FL
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