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General NPI Number Information
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NPI Number | 1790426013
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Entity Type | Organization
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Legal Business Name | BEEHAVIOR THERAPY FOR AUTISM
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Dates
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Enumeration Date | 04/02/2022
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Last Update Date | 04/02/2022
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Provider Practice Location Address
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Address Line | 4449 NW 92ND AVE
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City | SUNRISE
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State | FL
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Zip | 33351-5256
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Country | US
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Telephone | 954-662-3978
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Fax |
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Provider Business Mailing Address
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Address Line | 4449 NW 92ND AVE
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City | SUNRISE
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State | FL
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Zip | 33351-5256
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Country | US
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Telephone | 954-662-3978
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NIURKA BAEZ
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Credential | BCBA
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Telephone | 954-662-3978
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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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