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General NPI Number Information
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NPI Number | 1891200051
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Entity Type | Organization
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Legal Business Name | THE MISSING PIECE BEHAVIORAL THERAPY LLC
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Dates
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Enumeration Date | 12/11/2017
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Last Update Date | 12/11/2017
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Provider Practice Location Address
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Address Line | 99 NW 183RD ST
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33169-4502
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Country | US
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Telephone | 786-402-6889
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Fax |
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Provider Business Mailing Address
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Address Line | 99 NW 183RD ST
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33169-4502
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Country | US
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Telephone | 786-402-6889
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | COUTCHARD POINT DU JOUR
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Credential |
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Telephone | 786-402-6889
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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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