| NPI | 1265140685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA BUSTAMANTE President 954-547-9331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X |
| 106S00000X Behavior Technician | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2023-01-23 |