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Organization

FENIX BEHAVIOR THERAPY CO.

Active
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Organization

FENIX BEHAVIOR THERAPY CO.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUCEL TEJEDA BCBA (CLINICAL DIRECTOR)
(239) 628-6999
Entity
Organization

Contact information

Practice address
1705 COLONIAL BLVD STE B4, FORT MYERS, FL 33907-1141
(239) 628-6999
Mailing address
6660 ESTERO BLVD UNIT B404, FORT MYERS BEACH, FL 33931-4567
(239) 628-6999

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
04/26/2018
Last updated
07/23/2024
About Stedi
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  • EDI platform