Provider Demographics
NPI:1659030989
Name:M&W BEHAVIOR THERAPY LLC
Entity Type:Organization
Organization Name:M&W BEHAVIOR THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MILEIDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-800-1982
Mailing Address - Street 1:2050 W CROWN POINTE BLVD APT 211
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-3646
Mailing Address - Country:US
Mailing Address - Phone:786-800-1982
Mailing Address - Fax:
Practice Address - Street 1:2050 W CROWN POINTE BLVD APT 211
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-3646
Practice Address - Country:US
Practice Address - Phone:786-800-1982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty