| Energy Behavioral Therapy Corp | |
|
1701 Se Tiffany Ave Ste 102 Port St Lucie FL 34952-7576 | |
| (786) 227-2966 | |
| Not Available |
| Full Name | Energy Behavioral Therapy Corp |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1701 Se Tiffany Ave Ste 102, Port St Lucie, Florida |
| Authorized Official Name and Position | Ernesto Rodriguez Tanquero (PRESIDENT) |
| Authorized Official Contact | 7862272966 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Energy Behavioral Therapy Corp 1701 Se Tiffany Ave Ste 102 Port St Lucie FL 34952-7576 Ph: (786) 227-2966 | Energy Behavioral Therapy Corp 1701 Se Tiffany Ave Ste 102 Port St Lucie FL 34952-7576 Ph: (786) 227-2966 |
| NPI Number | 1194437202 |
|---|---|
| Provider Enumeration Date | 12/20/2022 |
| Last Update Date | 12/20/2022 |
| Certification Date | 12/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194437202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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