Provider Demographics
NPI:1518679893
Name:MAGIC TOUCH THERAPY LLC
Entity Type:Organization
Organization Name:MAGIC TOUCH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YANAIKY
Authorized Official - Middle Name:CARIDAD
Authorized Official - Last Name:GUTIERREZ DE LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-590-1682
Mailing Address - Street 1:8241 NW 165TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-3471
Mailing Address - Country:US
Mailing Address - Phone:305-590-1682
Mailing Address - Fax:
Practice Address - Street 1:8241 NW 165TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-3471
Practice Address - Country:US
Practice Address - Phone:305-590-1682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty