Provider Demographics
NPI:1881446912
Name:MINDFUL KIDS THERAPY LLC
Entity type:Organization
Organization Name:MINDFUL KIDS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YULEISVI
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:786-208-7539
Mailing Address - Street 1:92300 OVERSEAS HWY STE 207
Mailing Address - Street 2:
Mailing Address - City:TAVERNIER
Mailing Address - State:FL
Mailing Address - Zip Code:33070-2726
Mailing Address - Country:US
Mailing Address - Phone:786-208-7539
Mailing Address - Fax:
Practice Address - Street 1:92300 OVERSEAS HWY STE 207
Practice Address - Street 2:
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070-2726
Practice Address - Country:US
Practice Address - Phone:786-208-7539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty