Phoenix House of Support Corp

NPI #1356897300 in Cutler Bay, Florida

Provider Information

NPI Number: 1356897300
Entity Type: Organization
Organization Name: Phoenix House of Support Corp
Primary Specialty: Behavior Analyst
Enumeration Date: Aug 30, 2016
Last Updated: Aug 30, 2016

Practice Location

Address: 8902 SW 208TH TER
City: Cutler Bay
State: Florida
ZIP Code: 33189-3884
Phone: (786) 301-1571

Authorized Official

Name: TAMARA VIQUILLON
Title: OWNER
Phone: (786) 301-1571

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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