Provider Demographics
NPI:1619678992
Name:ABA MAGIC THERAPY CORP
Entity Type:Organization
Organization Name:ABA MAGIC THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAYTE
Authorized Official - Middle Name:SOFIA
Authorized Official - Last Name:MOURINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-999-5244
Mailing Address - Street 1:10470 NW 134TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1105
Mailing Address - Country:US
Mailing Address - Phone:786-999-5244
Mailing Address - Fax:
Practice Address - Street 1:10470 NW 134TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-1105
Practice Address - Country:US
Practice Address - Phone:786-999-5244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty