Provider Demographics
NPI:1396446365
Name:THERAPY TREE MIAMI LLC
Entity type:Organization
Organization Name:THERAPY TREE MIAMI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:JANAE
Authorized Official - Last Name:CLARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-282-2923
Mailing Address - Street 1:6175 NW 167TH ST STE G11
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4348
Mailing Address - Country:US
Mailing Address - Phone:786-282-2923
Mailing Address - Fax:
Practice Address - Street 1:6175 NW 167TH ST STE G11
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4348
Practice Address - Country:US
Practice Address - Phone:786-282-2923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty