Provider Demographics
NPI:1356684054
Name:PUTTING THE PIECES TOGETHER BEHAVIORAL THERAPY
Entity Type:Organization
Organization Name:PUTTING THE PIECES TOGETHER BEHAVIORAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:BERTRAND-ZELAYA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:603-738-9369
Mailing Address - Street 1:1355 MARIPOSA CIR APT 102
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-7259
Mailing Address - Country:US
Mailing Address - Phone:603-738-9369
Mailing Address - Fax:
Practice Address - Street 1:1355 MARIPOSA CIR APT 102
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-7259
Practice Address - Country:US
Practice Address - Phone:603-738-9369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-12-10161251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health