Provider Demographics
NPI:1982363263
Name:UNIQUELY ME THERAPIES LLC
Entity Type:Organization
Organization Name:UNIQUELY ME THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/INDEPENDENT CONTRACTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:STAUDACHER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:734-945-6473
Mailing Address - Street 1:7712 UNICORN TAPESTRY CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-0437
Mailing Address - Country:US
Mailing Address - Phone:734-945-6473
Mailing Address - Fax:
Practice Address - Street 1:7712 UNICORN TAPESTRY CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-0437
Practice Address - Country:US
Practice Address - Phone:734-945-6473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty