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General NPI Number Information
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NPI Number | 1740695972
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Entity Type | Organization
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Legal Business Name | CHANGING BEHAVIOR TOGETHER
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Dates
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Enumeration Date | 06/26/2014
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Last Update Date | 06/26/2014
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Provider Practice Location Address
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Address Line | 218 SE 14TH ST SUITE 2005
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City | MIAMI
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State | FL
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Zip | 33131-3325
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Country | US
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Telephone | 305-775-6005
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Fax |
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Provider Business Mailing Address
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Address Line | 218 SE 14TH ST SUITE 2005
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City | MIAMI
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State | FL
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Zip | 33131-3325
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Country | US
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Telephone | 305-775-6005
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ADAM VENTURA
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Credential |
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Telephone | 305-775-6005
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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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