Provider Demographics
NPI:1457875676
Name:COSMIC KIDS THERAPY, INC.
Entity type:Organization
Organization Name:COSMIC KIDS THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LIMIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-319-1610
Mailing Address - Street 1:9074 SW 153RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-2932
Mailing Address - Country:US
Mailing Address - Phone:786-319-1610
Mailing Address - Fax:
Practice Address - Street 1:9074 SW 153RD COURT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196
Practice Address - Country:US
Practice Address - Phone:786-319-1610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty