Provider Demographics
NPI:1093122921
Name:DR. EVA THERAPY
Entity Type:Organization
Organization Name:DR. EVA THERAPY
Other - Org Name:MY TREETOP CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENMELEH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:786-383-4942
Mailing Address - Street 1:221 WEST HALLANDALE BEACH BOULEVARD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2310
Mailing Address - Country:US
Mailing Address - Phone:786-383-4942
Mailing Address - Fax:
Practice Address - Street 1:221 WEST HALLANDALE BEACH BOULEVARD
Practice Address - Street 2:SUITE 202
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2310
Practice Address - Country:US
Practice Address - Phone:786-383-4942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-11
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8656103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty