Provider Demographics
NPI:1093360398
Name:CORNERSTONE BEHAVIORAL ANALYSIS
Entity type:Organization
Organization Name:CORNERSTONE BEHAVIORAL ANALYSIS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EIMI
Authorized Official - Middle Name:MEJIA
Authorized Official - Last Name:TRUJILLO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:786-475-5732
Mailing Address - Street 1:12920 SW 133RD CT UNIT 11
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6149
Mailing Address - Country:US
Mailing Address - Phone:786-475-5732
Mailing Address - Fax:844-455-3224
Practice Address - Street 1:12920 SW 133RD CT UNIT 11
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6149
Practice Address - Country:US
Practice Address - Phone:786-475-5732
Practice Address - Fax:844-455-3224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-05
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty