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General NPI Number Information
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NPI Number | 1659016731
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Entity Type | Organization
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Legal Business Name | BRILLIANT MINDS THERAPY SERVICES LLC
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Dates
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Enumeration Date | 05/03/2022
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 5440 PARK CENTRAL CT
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City | NAPLES
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State | FL
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Zip | 34109-6003
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Country | US
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Telephone | 786-720-2747
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Fax |
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Provider Business Mailing Address
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Address Line | 5440 PARK CENTRAL CT
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City | NAPLES
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State | FL
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Zip | 34109-6003
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Country | US
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Telephone | 786-720-2747
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Fax |
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Authorized Official
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Title or Position | MANGING MEMBER
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Name | SABRINA LUNA
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Credential |
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Telephone | 786-720-2747
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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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