=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831962893
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABA THERAPY AND EDUCATION CONSULTANTS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/01/2023
-----------------------------------------------------
Last Update Date | 11/02/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8911 SW 208TH TER
-----------------------------------------------------
City | CUTLER BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33189-3885
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-615-9693
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8911 SW 208TH TER
-----------------------------------------------------
City | CUTLER BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33189-3885
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-615-9693
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MRS. LE MARTINEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-615-9693
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------