Provider Demographics
NPI:1659971299
Name:BIEN-AIME, JUDITH M
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:M
Last Name:BIEN-AIME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5746
Mailing Address - Country:US
Mailing Address - Phone:954-532-0337
Mailing Address - Fax:954-208-0680
Practice Address - Street 1:4800 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-5746
Practice Address - Country:US
Practice Address - Phone:954-532-0337
Practice Address - Fax:954-208-0680
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-146176106S00000X
FL222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician