Provider Demographics
NPI:1063121564
Name:COGNIVERSITY LLC
Entity type:Organization
Organization Name:COGNIVERSITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ZEREANA
Authorized Official - Middle Name:
Authorized Official - Last Name:JESS-HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-452-3158
Mailing Address - Street 1:1431 MARINA MILE BLVD # 3-102
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33315-2384
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1431 MARINA MILE BLVD # 3-102
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33315-2384
Practice Address - Country:US
Practice Address - Phone:210-452-3158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty