Provider Demographics
NPI:1578196200
Name:KID CENTERED THERAPY TWO LLC
Entity Type:Organization
Organization Name:KID CENTERED THERAPY TWO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SIRIPORN
Authorized Official - Middle Name:
Authorized Official - Last Name:CERBER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, BCBA
Authorized Official - Phone:561-460-0284
Mailing Address - Street 1:777 S FLAGLER DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-6161
Mailing Address - Country:US
Mailing Address - Phone:561-460-0284
Mailing Address - Fax:561-473-9623
Practice Address - Street 1:777 S FLAGLER DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-6161
Practice Address - Country:US
Practice Address - Phone:561-460-0284
Practice Address - Fax:561-473-9623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty