Provider Demographics
NPI:1740961655
Name:AMG CORP BEHAVIOR ANALYSIS
Entity type:Organization
Organization Name:AMG CORP BEHAVIOR ANALYSIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRERO GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:917-439-9766
Mailing Address - Street 1:10661 N KENDALL DR STE 109
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1593
Mailing Address - Country:US
Mailing Address - Phone:917-439-9766
Mailing Address - Fax:
Practice Address - Street 1:10661 N KENDALL DR STE 109
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1593
Practice Address - Country:US
Practice Address - Phone:917-439-9766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty