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General NPI Number Information
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NPI Number | 1750093480
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Entity Type | Organization
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Legal Business Name | BEHAVIOR CHANGE THERAPEUTICS,INC
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Dates
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Enumeration Date | 12/13/2022
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 3401 NW 82ND AVE STE 105E
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City | DORAL
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State | FL
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Zip | 33122-1052
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Country | US
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Telephone | 786-620-0830
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 NW 82ND AVE STE 105E
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City | DORAL
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State | FL
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Zip | 33122-1052
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Country | US
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Telephone | 786-620-0830
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MAYRELIS DELGADO
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Credential |
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Telephone | 786-620-0830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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