Provider Demographics
NPI:1093874984
Name:HYPNOSIS AND THERAPY CENTER
Entity Type:Organization
Organization Name:HYPNOSIS AND THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:PAULA
Authorized Official - Last Name:VALIENTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-661-1238
Mailing Address - Street 1:6601 SW 80TH STREET SUITE 208
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143
Mailing Address - Country:US
Mailing Address - Phone:305-663-5857
Mailing Address - Fax:305-661-1238
Practice Address - Street 1:6601 SW 80TH STREET SUITE 208
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143
Practice Address - Country:US
Practice Address - Phone:305-663-5857
Practice Address - Fax:305-661-1238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5355103T00000X
FLMH2862103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty