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General NPI Number Information
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NPI Number | 1790057255
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Entity Type | Organization
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Legal Business Name | THE HEALING PATH
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Dates
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Enumeration Date | 01/30/2012
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Last Update Date | 01/30/2012
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Provider Practice Location Address
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Address Line | 8051 NW 36TH ST STE 609
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City | DORAL
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State | FL
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Zip | 33166-6626
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Country | US
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Telephone | 786-845-9553
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Fax |
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Provider Business Mailing Address
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Address Line | 5330 NW 114TH AVE UNIT 104
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City | DORAL
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State | FL
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Zip | 33178-3598
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Country | US
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Telephone | 305-562-9698
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. CATALINA ALVAREZ
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Credential | LMFT; BCBA
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Telephone | 305-562-9698
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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 | 1-08-4242
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT1265
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License Number State | FL
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