| Fenix Behavior Therapy Co. | |
|
1705 Colonial Blvd Ste B4 Fort Myers FL 33907-1141 | |
| (239) 628-6999 | |
| Not Available |
| Full Name | Fenix Behavior Therapy Co. |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1705 Colonial Blvd Ste B4, Fort Myers, Florida |
| Authorized Official Name and Position | Sucel Tejeda (CLINICAL DIRECTOR) |
| Authorized Official Contact | 2396286999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fenix Behavior Therapy Co. 6660 Estero Blvd Unit B404 Fort Myers Beach FL 33931-4567 Ph: (239) 628-6999 | Fenix Behavior Therapy Co. 1705 Colonial Blvd Ste B4 Fort Myers FL 33907-1141 Ph: (239) 628-6999 |
| NPI Number | 1184112906 |
|---|---|
| Provider Enumeration Date | 04/26/2018 |
| Last Update Date | 07/23/2024 |
| Certification Date | 07/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184112906 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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