| Metamorphosis Therapy Llc | |
|
1450 Daniels Rd Winter Garden FL 34787-4376 | |
| (407) 395-9976 | |
| Not Available |
| Full Name | Metamorphosis Therapy Llc |
|---|---|
| Speciality | Behavior Technician |
| Location | 1450 Daniels Rd, Winter Garden, Florida |
| Authorized Official Name and Position | Bridgett Elaine Dimant (OWNER) |
| Authorized Official Contact | 4072857907 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Metamorphosis Therapy Llc 13750 W Colonial Dr Ste 350-121 Winter Garden FL 34787-4204 Ph: (407) 395-9976 | Metamorphosis Therapy Llc 1450 Daniels Rd Winter Garden FL 34787-4376 Ph: (407) 395-9976 |
| NPI Number | 1477008407 |
|---|---|
| Provider Enumeration Date | 08/19/2016 |
| Last Update Date | 08/22/2023 |
| Certification Date | 08/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477008407 | NPI | - | NPPES |
| 017434700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Primary |
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