MEDICARE: BEHAVIORAL BRIDGES THERAPY, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	106E00000X	Assistant Behavior Analyst
2	106S00000X	Behavior Technician
3	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1366203739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIORAL BRIDGES THERAPY, LLC.

Provider Business Mailing Address
First Line	:	4560 SW 128TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-4610
Country	:	US
Telephone Number	:	786-973-7474
Fax Number	:

Provider Business Practice Location Address
First Line	:	4560 SW 128TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-4610
Country	:	US
Telephone Number	:	786-973-7474
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	SABRINA GUEDES
Credential	:
Telephone Number	:	786-973-7474

Provider Enumeration Date	:	01/22/2024
Last Update Date	:	01/22/2024

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