Provider Demographics
NPI:1073232831
Name:KIDS MAGICAL ABA WORLD LLC
Entity Type:Organization
Organization Name:KIDS MAGICAL ABA WORLD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHALY
Authorized Official - Middle Name:
Authorized Official - Last Name:WICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-781-0988
Mailing Address - Street 1:11260 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11260 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1106
Practice Address - Country:US
Practice Address - Phone:305-781-0988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-24
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty