Provider Demographics
NPI:1477248342
Name:SKILLFUL MINDS BEHAVIOR ANALYSIS INC
Entity Type:Organization
Organization Name:SKILLFUL MINDS BEHAVIOR ANALYSIS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:DEL CARMEN
Authorized Official - Last Name:GONZALEZ LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-566-8000
Mailing Address - Street 1:1801 NE 123RD ST STE 332
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2883
Mailing Address - Country:US
Mailing Address - Phone:786-566-8000
Mailing Address - Fax:
Practice Address - Street 1:1801 NE 123RD ST STE 332
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2883
Practice Address - Country:US
Practice Address - Phone:786-566-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty