Provider Demographics
NPI:1013628791
Name:BLUE BUTTERFLY THERAPY LLC
Entity type:Organization
Organization Name:BLUE BUTTERFLY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILIAN YNFANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-803-1621
Mailing Address - Street 1:3187 NW 60TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-2104
Mailing Address - Country:US
Mailing Address - Phone:786-803-1621
Mailing Address - Fax:
Practice Address - Street 1:3187 NW 60TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-2104
Practice Address - Country:US
Practice Address - Phone:786-803-1621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty